Organization
CONCOURSE MEDICAL ASSOCIATES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
H EDWARD KLEMPTNER M.D. (PRESIDENT)
(847) 583-0939
Entity
Organization
Contact information
Practice address
5410 WARREN ST, MORTON GROVE, IL 60053-3639
(847) 583-0939
(847) 583-0945
Mailing address
PO BOX 388320, CHICAGO, IL 60638-8320
(773) 767-4600
(773) 767-8320
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036026661
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01607179
BLUE SHIELD
IL
05
—
036026661
—
IL
01
—
P00134710
RAILROAD MEDICARE
—
Enumeration date
07/16/2006
Last updated
08/28/2009
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