Organization
DAVID R EDELSTEIN MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID R. EDELSTEIN M.D. (PRESIDENT)
(312) 332-3699
Entity
Organization
Contact information
Practice address
1917 WESTLEIGH DR, GLENVIEW, IL 60025-7612
(312) 332-3699
(312) 332-3698
Mailing address
30 N MICHIGAN AVE, SUITE 501, CHICAGO, IL 60602-3402
(312) 332-3699
(312) 332-3698
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-047656
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21606223
BLUE CROSS OF ILLINOIS
—
Enumeration date
07/14/2005
Last updated
06/14/2021
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