1033286018 NPI number — DR. DANUTA EHRLICH PHD

Table of content: DR. DANUTA EHRLICH PHD (NPI 1033286018)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033286018 NPI number — DR. DANUTA EHRLICH PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EHRLICH
Provider First Name:
DANUTA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033286018
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
70 WEST BURTON PLACE
Provider Second Line Business Mailing Address:
APT 2001
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-664-3749
Provider Business Mailing Address Fax Number:
312-664-3749

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 NORTH MICHIGAN AVENUE
Provider Second Line Business Practice Location Address:
SUITE 1801
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-266-0755
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1672064 . This is a "BCBS PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6167529 . This is a "UBH" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com