# MICHAEL J VERTA JR, MDSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275645590
- **Authorized official:** MICHAEL J VERTA JR. MD (PRESIDENT)
- **Authorized official phone:** (847) 205-0050

## Contact information

- **Practice address:** 1000 CENTRAL ST, SUITE 800, EVANSTON, IL 60201-1777
- **Practice address phone:** (847) 205-0050
- **Practice address fax:** (847) 256-2931
- **Mailing address:** 321 RALEIGH RD, KENILWORTH, IL 60043-1253
- **Mailing address phone:** (847) 205-0050
- **Mailing address fax:** (847) 256-2931

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | IL | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 21607920 | BCBS OF IL | IL |