Individual
DR. MAX D KOENIGSBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 296-7054
(773) 296-7818
Mailing address
1550 N. LAKE SHORE DR, 19 G, CHICAGO, IL 60610-6602
(312) 642-5662
(312) 944-7185
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-060719
IL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
036-060719
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-060719
—
IL
Enumeration date
06/27/2006
Last updated
02/04/2015
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