Individual
LINAS A. SIDRYS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5706 111TH ST, CHICAGO RIDGE, IL 60415-2407
(708) 636-6622
Mailing address
5706 111TH ST, CHICAGO RIDGE, IL 60415-2407
(708) 636-6622
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036-058239
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-058239
ILLINOIS LCENSE
IL
01
—
05032013
BLUE CROSS
IL
01
—
180009600
RAILROAD MEDICARE
IL
01
—
180046260
RAILROAD MEDICARE
IL
01
—
207W00000X
TAXONOMY CODE
IL
01
—
21629784
BLUE CROSS
IL
Enumeration date
10/27/2006
Last updated
12/22/2021
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