Provider Demographics
NPI:1538231188
Name:FIRLIT, GEORGE STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:STEPHEN
Last Name:FIRLIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 GOLF ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1600
Mailing Address - Country:US
Mailing Address - Phone:847-296-0303
Mailing Address - Fax:847-296-4902
Practice Address - Street 1:9301 GOLF ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1600
Practice Address - Country:US
Practice Address - Phone:847-296-0303
Practice Address - Fax:847-296-4902
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036056864207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036056864Medicaid
IL01615954OtherBLUE CROSS BLUE SHIELD
200001098Medicare PIN
P12522Medicare PIN
C45581Medicare UPIN
796180Medicare PIN
IL036056864Medicaid
1019820001Medicare NSC