Organization
MEDICAL SERVICES RIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN TINGSTAD (SR. VP AND CHIEF FINANCIAL OFFICER)
(312) 238-1000
Entity
Organization
Contact information
Practice address
355 E. ERIE ST., CHICAGO, IL 60611
(312) 238-1000
Mailing address
355 E. ERIE ST, CHICAGO, IL 60611-2654
(312) 238-1000
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208200000X
Plastic Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/11/2006
Last updated
12/06/2022
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