Individual
DAVID I. KOENIGSBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9650 GROSS POINT RD STE 4900, SKOKIE, IL 60076
(847) 663-8410
(847) 676-1727
Mailing address
9650 GROSS POINT RD STE 4900, SKOKIE, IL 60076-1214
(847) 663-8410
(847) 676-1727
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036053305
IL
207RC0000X
Cardiovascular Disease Physician
Primary
036053305
IL
207RI0011X
Interventional Cardiology Physician
036053305
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053305
—
IL
01
—
060020165
RAILROAD MEDICARE
IL
01
—
1617522
BCBS
IL
01
—
234690
HARMONY HEALTH IL ID
IL
01
—
282012-1
LICENSE
NY
01
—
K47968
MEDICARE PTAN
IL
Enumeration date
09/26/2005
Last updated
10/06/2020
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