1932195716 NPI number — WILLIAM ADAIR MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932195716 NPI number — WILLIAM ADAIR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADAIR
Provider First Name:
WILLIAM
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1932195716
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 OAKMONT LN
Provider Second Line Business Mailing Address:
SUITE 1600
Provider Business Mailing Address City Name:
WESTMONT
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60559-5511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-288-6215
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4440 W 95TH ST
Provider Second Line Business Practice Location Address:
EMG LAB, ROOM 042 SOUTH
Provider Business Practice Location Address City Name:
OAK LAWN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60453-2600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-684-5428
Provider Business Practice Location Address Fax Number:
708-684-2079
Provider Enumeration Date:
09/27/2005

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: 208100000X , 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: 47616 . This is a "ADVOCATE HLTH PARTNERS ID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 01621490 . This is a "BCBS PROVIDER ID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 36354817302 . This is a "ADVOCATE HLTH CENTERS ID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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