Provider Demographics
NPI:1235479858
Name:NORMAN M JAMES, M.D., LTD
Entity type:Organization
Organization Name:NORMAN M JAMES, M.D., LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:MILLARD
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-225-2055
Mailing Address - Street 1:2555 S. MARTIN LUTHER KING DR
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2419
Mailing Address - Country:US
Mailing Address - Phone:312-225-2055
Mailing Address - Fax:312-225-7437
Practice Address - Street 1:2555 S KING DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2419
Practice Address - Country:US
Practice Address - Phone:312-225-2055
Practice Address - Fax:312-225-7437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036053299207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036053299Medicaid
IL036053299Medicaid
IL643281Medicare PIN