Organization
CHARLES B HOLMES, MD, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES B HOLMES MD (PRESIDENT)
(773) 221-1690
Entity
Organization
Contact information
Practice address
10547 S EWING AVE, CHICAGO, IL 60617-6220
(773) 221-1690
(773) 221-1675
Mailing address
7703 S CREGIER AVE, CHICAGO, IL 60649-4609
(773) 221-1690
(773) 221-1675
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01627279
BCBS
IL
Enumeration date
07/30/2006
Last updated
04/30/2015
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