Active NPI 1710994215 Individual Practitioner Male Practitioner

Dr. Edward Daniel Kogan , MD

Internal Medicine • Hoffman Estates, IL

Professional Overview & Biography Verified Profile Summary

Dr. Edward Kogan, MD is a registered healthcare professional specializing in Internal Medicine in Hoffman Estates, IL. Practice services are available at 3100 W HIGGINS RD STE 125 under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, insertion of needle into vein for collection of blood sample, blood test, comprehensive group of blood chemicals. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

3100 W Higgins Rd Ste 125

Hoffman Estates, IL 601697203

Telephone 8478847111

Fax 8478847156

Associated Practice Facility / Clinic

🏢 Westbrook Internal Medicine, S.c. Facility NPI 1487663431

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Hoffman Estates, IL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 29.4 Yrs

State Avg: 28.9 Yrs

Regional Practice Density

35 Specialists

Practicing in Hoffman Estates, IL (7544 Statewide)

Telehealth Adoption Rate

28.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

60.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	802	413	$229.00	$135.18
36415 Insertion of needle into vein for collection of blood sample	542	351	$20.00	$2.96
80053 Blood test, comprehensive group of blood chemicals	486	339	$55.00	$10.41
80061 Blood test, lipids (cholesterol and triglycerides)	454	320	$69.00	$13.20
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	451	321	$40.00	$7.66
83036 Hemoglobin A1C level	192	132	$50.00	$9.57
93000 Routine ekg using at least 12 leads including interpretation and report	177	174	$72.00	$15.44
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	137	137	$229.00	$138.03
82570 Creatinine level to test for kidney function or muscle injury	128	82	$27.00	$5.10
82043 Urine microalbumin (protein) level	128	82	$30.00	$5.69
84443 Blood test, thyroid stimulating hormone (TSH)	113	104	$86.00	$16.61
99213 Established patient office or other outpatient visit, typically 15 minutes	92	77	$157.00	$95.84
G0103 Prostate cancer screening; prostate specific antigen test (psa)	47	47	$52.00	$19.05
82306 Vitamin d-3 level	39	39	$152.00	$29.33
84550 Uric acid level, blood	37	32	$23.00	$4.47
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	32	30	$307.00	$192.53
85652 Red blood cell sedimentation rate, to detect inflammation, automated	27	25	$14.00	$2.67
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	25	24	$114.00	$56.22
G0009 Administration of pneumococcal vaccine	25	25	$55.00	$31.37
99442 Telephone medical discussion with physician, 11-20 minutes	24	21	$179.00	$96.00
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	23	23	$352.00	$176.98
82728 Ferritin (blood protein) level	22	20	$70.00	$13.48
84153 Psa (prostate specific antigen) measurement, total	20	18	$94.00	$18.22
84439 Thyroxine (thyroid chemical), free	18	17	$46.00	$8.94
83540 Iron level	15	13	$33.00	$6.42
83550 Iron binding capacity	15	13	$45.00	$8.66
82607 Cyanocobalamin (vitamin B-12) level	15	14	$77.00	$14.87
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	14	14	$851.00	$278.66
G0008 Administration of influenza virus vaccine	13	12	$55.00	$31.22
84132 Blood potassium level	12	11	$25.00	$4.72
83735 Magnesium level	12	12	$34.00	$6.64
86141 Measurement c-reactive protein for detection of infection or inflammation, high sensitivity	11	11	$67.00	$12.77

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,063	460	$229.00	$139.87
36415 Insertion of needle into vein for collection of blood sample	781	429	$20.00	$3.00
80053 Blood test, comprehensive group of blood chemicals	666	409	$55.00	$10.52
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	656	406	$40.00	$7.74
80061 Blood test, lipids (cholesterol and triglycerides)	633	385	$69.00	$13.34
83036 Hemoglobin A1C level	274	152	$50.00	$9.65
93000 Routine ekg using at least 12 leads including interpretation and report	269	257	$72.00	$16.22
82570 Creatinine level to test for kidney function or muscle injury	202	111	$27.00	$5.16
82043 Urine microalbumin (protein) level	202	111	$30.00	$5.76
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	191	191	$229.00	$143.51
84443 Blood test, thyroid stimulating hormone (TSH)	162	133	$86.00	$16.80
G0008 Administration of influenza virus vaccine	144	143	$55.00	$17.98
90662 Influenza vaccine split virus, preservative free	137	137	$106.00	$65.23
99213 Established patient office or other outpatient visit, typically 15 minutes	116	90	$157.00	$97.59
82306 Vitamin d-3 level	80	77	$152.00	$29.29
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	69	65	$307.00	$196.55
84550 Uric acid level, blood	66	54	$23.00	$4.52
85610 Blood test, clotting time	59	16	$20.00	$4.29
G0103 Prostate cancer screening; prostate specific antigen test (psa)	43	43	$52.00	$19.31
85652 Red blood cell sedimentation rate, to detect inflammation, automated	42	41	$14.00	$2.70
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	42	42	$352.00	$181.11
84439 Thyroxine (thyroid chemical), free	39	33	$46.00	$9.02
G0009 Administration of pneumococcal vaccine	36	36	$55.00	$17.92
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	30	26	$114.00	$57.20
83735 Magnesium level	28	24	$34.00	$6.70
82607 Cyanocobalamin (vitamin B-12) level	27	22	$77.00	$15.08
84153 Psa (prostate specific antigen) measurement, total	25	24	$94.00	$18.39
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	24	24	$361.00	$124.67
82728 Ferritin (blood protein) level	24	22	$70.00	$13.63
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r	21	19	$300.00	$75.00
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	19	17	$43.00	$24.47
99442 Telephone medical discussion with physician, 11-20 minutes	19	18	$109.53	$92.29
83550 Iron binding capacity	14	13	$45.00	$8.74
83540 Iron level	14	13	$33.00	$6.47
90670 Pneumococcal vaccine for injection into muscle	12	12	$254.00	$236.70
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	12	12	$340.00	$181.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	918	380	$229.00	$117.39
36415 Insertion of needle into vein for collection of blood sample	671	340	$20.00	$2.98
80053 Blood test, comprehensive group of blood chemicals	565	325	$55.00	$10.50
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	551	329	$40.00	$7.73
80061 Blood test, lipids (cholesterol and triglycerides)	534	309	$69.00	$13.32
93000 Routine ekg using at least 12 leads including interpretation and report	238	220	$72.00	$18.59
83036 Hemoglobin A1C level	208	114	$50.00	$9.66
82570 Creatinine level to test for kidney function or muscle injury	170	94	$27.00	$5.15
82043 Urine microalbumin (protein) level	170	94	$30.00	$5.75
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	167	167	$229.00	$124.52
G0008 Administration of influenza virus vaccine	130	129	$55.00	$17.74
90662 Influenza vaccine split virus, preservative free	123	122	$106.00	$60.88
84443 Blood test, thyroid stimulating hormone (TSH)	118	101	$86.00	$16.73
99213 Established patient office or other outpatient visit, typically 15 minutes	112	95	$157.00	$81.09
82306 Vitamin d-3 level	99	91	$152.00	$29.39
G0009 Administration of pneumococcal vaccine	73	73	$55.00	$17.65
85610 Blood test, clotting time	69	18	$20.00	$4.27
84550 Uric acid level, blood	59	43	$23.00	$4.50
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	57	51	$307.00	$157.93
85652 Red blood cell sedimentation rate, to detect inflammation, automated	54	49	$14.00	$2.68
83735 Magnesium level	45	36	$34.00	$6.65
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	40	40	$325.45	$118.54
G0103 Prostate cancer screening; prostate specific antigen test (psa)	38	38	$52.00	$19.20
90670 Pneumococcal vaccine for injection into muscle	33	33	$254.00	$224.32
99442 Telephone medical discussion with physician, 11-20 minutes	27	26	$202.15	$81.35
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	26	23	$114.00	$57.41
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	24	24	$352.00	$183.44
82607 Cyanocobalamin (vitamin B-12) level	24	22	$77.00	$15.01
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	22	21	$43.00	$24.96
84439 Thyroxine (thyroid chemical), free	22	17	$46.00	$9.00
84153 Psa (prostate specific antigen) measurement, total	19	17	$94.00	$18.37
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r	16	16	$300.00	$100.00
82728 Ferritin (blood protein) level	16	13	$70.00	$13.55
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	16	16	$340.00	$177.91
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	16	16	$39.00	$18.49
99441 Telephone medical discussion with physician, 5-10 minutes	12	12	$71.50	$47.50
86769 Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody	11	11	$126.00	$42.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,161	435	$229.00	$114.74
36415 Insertion of needle into vein for collection of blood sample	706	353	$20.00	$2.94
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	584	338	$40.00	$8.46
80053 Blood test, comprehensive group of blood chemicals	581	334	$55.00	$11.51
80061 Blood test, lipids (cholesterol and triglycerides)	547	318	$69.00	$14.56
93000 Routine ekg using at least 12 leads including interpretation and report	237	213	$72.00	$18.30
83036 Hemoglobin A1C level	231	124	$50.00	$10.50
99213 Established patient office or other outpatient visit, typically 15 minutes	200	154	$157.00	$78.85
84443 Blood test, thyroid stimulating hormone (TSH)	172	151	$86.00	$18.30
82306 Vitamin d-3 level	145	120	$152.00	$31.85
82043 Urine microalbumin (protein) level	143	80	$30.00	$6.25
82570 Creatinine level to test for kidney function or muscle injury	143	80	$27.00	$5.60
G0008 Administration of influenza virus vaccine	130	130	$55.00	$17.33
90662 Influenza vaccine split virus, preservative free	108	108	$106.00	$54.89
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	107	107	$229.00	$123.76
G0009 Administration of pneumococcal vaccine	96	96	$55.00	$17.35
85610 Blood test, clotting time	90	20	$20.00	$4.28
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	81	81	$352.00	$182.82
85652 Red blood cell sedimentation rate, to detect inflammation, automated	79	69	$14.00	$2.94
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	75	66	$307.00	$155.36
90670 Pneumococcal vaccine for injection into muscle	73	73	$254.00	$209.24
83735 Magnesium level	53	45	$34.00	$7.29
84550 Uric acid level, blood	51	43	$23.00	$4.84
G0103 Prostate cancer screening; prostate specific antigen test (psa)	40	40	$52.00	$20.03
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	23	23	$124.00	$111.38
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	22	17	$114.00	$56.77
84439 Thyroxine (thyroid chemical), free	22	17	$46.00	$9.05
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	22	22	$38.00	$17.48
82728 Ferritin (blood protein) level	21	16	$70.00	$14.85
82607 Cyanocobalamin (vitamin B-12) level	18	17	$77.00	$16.41
84153 Psa (prostate specific antigen) measurement, total	15	15	$94.00	$20.03
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	15	15	$340.00	$176.93
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	12	12	$39.00	$18.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,055	409	$224.81	$109.38
36415 Insertion of needle into vein for collection of blood sample	596	324	$20.00	$2.93
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	473	298	$40.00	$9.36
80061 Blood test, lipids (cholesterol and triglycerides)	472	295	$69.00	$16.08
80053 Blood test, comprehensive group of blood chemicals	466	292	$55.00	$12.76
99213 Established patient office or other outpatient visit, typically 15 minutes	302	213	$152.64	$74.43
84443 Blood test, thyroid stimulating hormone (TSH)	223	188	$86.00	$20.33
93000 Routine ekg using at least 12 leads including interpretation and report	217	201	$72.15	$17.34
83036 Hemoglobin A1C level	206	118	$50.00	$11.55
G0009 Administration of pneumococcal vaccine	165	165	$55.00	$21.46
90670 Pneumococcal vaccine for injection into muscle	155	155	$254.00	$201.01
82306 Vitamin d-3 level	153	131	$152.00	$35.82
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	103	103	$352.00	$175.05
83735 Magnesium level	87	75	$34.00	$8.02
84439 Thyroxine (thyroid chemical), free	83	78	$46.00	$10.65
G0008 Administration of influenza virus vaccine	71	71	$55.00	$21.46
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	69	65	$304.96	$144.73
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	51	51	$38.00	$17.48
85610 Blood test, clotting time	48	18	$20.00	$4.75
85652 Red blood cell sedimentation rate, to detect inflammation, automated	38	37	$14.00	$3.18
G0103 Prostate cancer screening; prostate specific antigen test (psa)	36	36	$52.00	$22.26
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	35	35	$228.31	$118.83
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	27	23	$114.00	$55.01
84153 Psa (prostate specific antigen) measurement, total	27	25	$94.00	$22.26
84550 Uric acid level, blood	24	20	$23.00	$5.47
82728 Ferritin (blood protein) level	21	18	$70.00	$16.49
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	20	20	$40.00	$18.65
82550 Creatine kinase (cardiac enzyme) level, total	18	17	$33.00	$7.88
83550 Iron binding capacity	18	16	$45.00	$10.57
83540 Iron level	18	16	$33.00	$7.83
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	11	11	$323.64	$166.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	990	359	$170.00	$112.18
99213 Established patient office or other outpatient visit, typically 15 minutes	515	280	$110.00	$76.93
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	342	97	$120.00	$74.52
93000 Routine ekg using at least 12 leads including interpretation and report	193	166	$75.00	$18.05
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	98	98	$225.00	$121.54
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	88	67	$400.00	$214.32
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	84	72	$260.00	$151.16
G0008 Administration of influenza virus vaccine	65	65	$35.00	$26.42
Q2035 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)	65	65	$35.00	$17.34
99238 Hospital discharge day management, 30 minutes or less	52	44	$130.00	$75.43
99239 Hospital discharge day management, more than 30 minutes	47	37	$200.00	$111.19
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	45	11	$200.00	$108.40
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	33	30	$175.00	$55.73
G0009 Administration of pneumococcal vaccine	14	14	$35.00	$26.42
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	14	14	$123.21	$96.25

Medical Specialties & State Licenses

CMS Verified: 2021-02-24

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License IL 036058919

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License IL 336-023507

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

036-058919 (IL)

Commercial Insurance / Payer ID Bcbs Id

31603039 (IL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners

Dr. Nick Riccardo , MD

Internal Medicine

NPI 1124134879

Doctor of Medicine (M.D.)

Christina Raffini , PA-C

Physician Assistant

NPI 1225791189

Physician Assistant (Certified)

Dr. Ria Parcellano , MD

Family Medicine - Geriatric Medicine

NPI 1366708117

Doctor of Medicine (M.D.)

Dr. Gaston Carrasco , MD

Internal Medicine

NPI 1417052267

Doctor of Medicine (M.D.)

Dr. Norris Hsu , MD

Internal Medicine

NPI 1508961350

Doctor of Medicine (M.D.)

Dr. Mohammad Adnan Ul Haq , MD

Internal Medicine

NPI 1659805281

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events

📍

Updated Practice Location February 24, 2021

Registered at 3100 W HIGGINS RD STE 125, HOFFMAN ESTATES, IL 601697203 (Tel: 8478847111)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 03, 2019

Internal Medicine (License #336-023507 in IL)

✅

NPI Profile Active January 30, 2018

NPI status registered as active in NPPES database

📍

Updated Business Mailing Address January 30, 2018

Registered at 1860 PAYSHERE CIRCLE, CHICAGO, IL 606740001 (Tel: 6304699200)

📍

Updated Practice Location January 30, 2018

Registered at 1555 N BARRINGTON RD, DRS. BLDG. ONE, SUITE 505, HOFFMAN ESTATES, IL 601691066 (Tel: 8478847111)

👤

Provider Name / Credentials Updated January 30, 2018

Recorded as EDWARD KOGAN, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 30, 2018

Internal Medicine (License #036058919 in IL)

✅

NPI Profile Active January 11, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location January 11, 2013

Registered at 1555 N BARRINGTON RD, DRS. BLDG. ONE, SUITE 505, HOFFMAN ESTATES, IL 601691066 (Tel: 8478847111)

📍

Updated Business Mailing Address January 11, 2013

Registered at 1555 N BARRINGTON RD, DRS. BLDG. ONE, SUITE 505, HOFFMAN ESTATES, IL 601691066 (Tel: 8478847111)

👤

Provider Name / Credentials Updated January 11, 2013

Recorded as EDWARD KOGAN, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 11, 2013

Internal Medicine (License #036058919 in IL)

🟢

Initial NPI Registration & Enumeration August 01, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710994215

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 01, 2006

Last Update: February 24, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1860 Payshere Circle

Chicago, IL 606740001

Phone: 6304699200

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.