Organization
PHILIP H SHERIDAN JR SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP H SHERIDAN JR. M.D. (PRESIDENT)
(847) 774-7836
Entity
Organization
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
(847) 657-1960
(847) 446-1893
Mailing address
PO BOX 616, FOREST PARK, IL 60130-0616
(708) 366-7177
(708) 366-3301
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036079226
IL
207RP1001X
Pulmonary Disease Physician
Primary
036079226
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01637916
BLUE CROSS BLUE SHIELD
IL
05
—
036079226
—
IL
01
—
216062
MEDICARE
IL
Enumeration date
12/31/2007
Last updated
08/29/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us