Provider Demographics
NPI:1205886876
Name:CHEST MEDICINE CONSULTANTS, SC
Entity type:Organization
Organization Name:CHEST MEDICINE CONSULTANTS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:RIES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-935-5556
Mailing Address - Street 1:2800 N SHERIDAN RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6156
Mailing Address - Country:US
Mailing Address - Phone:773-935-5556
Mailing Address - Fax:773-935-2724
Practice Address - Street 1:2800 N SHERIDAN RD
Practice Address - Street 2:SUITE 301
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6156
Practice Address - Country:US
Practice Address - Phone:773-935-5556
Practice Address - Fax:773-935-2724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01616555OtherBLUE CROSS BLUE SHIELD
IL01616555OtherBLUE CROSS BLUE SHIELD
IL01616555OtherBLUE CROSS BLUE SHIELD
IL574180Medicare ID - Type Unspecified