Provider Demographics
NPI:1730214271
Name:GEORGE N ATIA, M.D., S.C.
Entity type:Organization
Organization Name:GEORGE N ATIA, M.D., S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:GEORGEOUS
Authorized Official - Middle Name:
Authorized Official - Last Name:MORCOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-881-5001
Mailing Address - Street 1:200 FOX GLEN CT
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1809
Mailing Address - Country:US
Mailing Address - Phone:847-382-7165
Mailing Address - Fax:847-713-8160
Practice Address - Street 1:200 FOX GLEN CT
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1809
Practice Address - Country:US
Practice Address - Phone:847-382-7165
Practice Address - Fax:847-713-8160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214879Medicare ID - Type UnspecifiedLAKE COUNTY
IL202028Medicare ID - Type UnspecifiedCOOK LAKE