Organization
CHICAGO NASAL AND SINUS CENTER S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN B PRITIKIN M.D. (SOLE PROPRIETOR)
(312) 372-9355
Entity
Organization
Contact information
Practice address
111 W WASHINGTON ST, SUITE 903, CHICAGO, IL 60602-2703
(312) 372-9355
(312) 372-9356
Mailing address
111 W WASHINGTON ST STE 903, CHICAGO, IL 60602-2762
(312) 372-9355
(312) 372-9356
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036-087346
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001633140
BLUE SHIELD
IL
01
—
040017908
RRMC
IL
Enumeration date
05/23/2006
Last updated
09/14/2023
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