Individual
EDWARD PASSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068
(847) 823-9800
(847) 823-9801
Mailing address
PO BOX 1447, MORTON GROVE, IL 60053-7447
(847) 823-9800
(847) 823-9801
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036066133
IL
2085R0202X
Diagnostic Radiology Physician
036066133
IL
2085U0001X
Diagnostic Ultrasound Physician
036066133
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01627348
BCBS
IL
05
—
036066133
—
IL
Enumeration date
02/19/2007
Last updated
12/20/2021
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