Provider Demographics
NPI:1134174527
Name:YOUSEF DARWISH MD.PC
Entity type:Organization
Organization Name:YOUSEF DARWISH MD.PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:DARWISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-316-3880
Mailing Address - Street 1:800 AUSTIN ST
Mailing Address - Street 2:SUITE 163
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3439
Mailing Address - Country:US
Mailing Address - Phone:847-316-3880
Mailing Address - Fax:847-316-3883
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:SUITE 163
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3439
Practice Address - Country:US
Practice Address - Phone:847-316-3880
Practice Address - Fax:847-316-3883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21623195OtherBLUE CROSS BS GROUP NO.
ILCA5882OtherRAIL ROAD MEDICARE
ILCA5882OtherRAIL ROAD MEDICARE
IL21623195OtherBLUE CROSS BS GROUP NO.