Individual
DR. SAMUEL SOLOMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
103 S GREENLEAF ST, SUITE J, GURNEE, IL 60031-3380
(847) 662-8201
(847) 662-8215
Mailing address
103 S GREENLEAF ST, SUITE J, GURNEE, IL 60031-3380
(847) 662-8201
(847) 662-8215
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36039961
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609827237
GROUP NPI
IL
01
—
4044905
AETNA
IL
01
—
6945148002
CIGNA
IL
01
—
89-101
WISCONSIN PROVIDER
WI
01
—
K39549
MEDICARE INDIVIDUAL NO.
IL
01
—
O4920144
BCBS
IL
Enumeration date
05/23/2006
Last updated
02/12/2008
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