MEDICARE: ENT SPECIALISTS, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	036-084344	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CM3993	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	022-15697	OTHER	IL	BC/BS PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952587511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENT SPECIALISTS, LTD

Provider Business Mailing Address
First Line	:	57 OGDEN AVE
Second Line	:
City	:	CLARENDON HILLS
State	:	IL
Zip	:	60514-1026
Country	:	US
Telephone Number	:	630-495-6000
Fax Number	:	630-495-6001

Provider Business Practice Location Address
First Line	:	57 OGDEN AVE
Second Line	:
City	:	CLARENDON HILLS
State	:	IL
Zip	:	60514-1026
Country	:	US
Telephone Number	:	630-495-6000
Fax Number	:	630-495-6001

Authorized Official
Title or Position	:	PRESIDENT/PHYSICIAN
Name	:	ANDREW JOSEPH SCHUBKEGEL
Credential	:	M.D.
Telephone Number	:	630-495-6000

Provider Enumeration Date	:	01/14/2008
Last Update Date	:	06/25/2024

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Directions to “ENT SPECIALISTS, LTD ” Practice Location

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