Organization
MICHAEL J VERTA JR, MDSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J VERTA JR. MD (PRESIDENT)
(847) 205-0050
Entity
Organization
Contact information
Practice address
1000 CENTRAL ST, SUITE 800, EVANSTON, IL 60201-1777
(847) 205-0050
(847) 256-2931
Mailing address
321 RALEIGH RD, KENILWORTH, IL 60043-1253
(847) 205-0050
(847) 256-2931
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21607920
BCBS OF IL
IL
Enumeration date
08/31/2006
Last updated
08/22/2020
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