Provider Demographics
NPI:1447337548
Name:SOUTHWEST INFECTIOUS DISEASE & INTERNAL MEDICINE S C
Entity type:Organization
Organization Name:SOUTHWEST INFECTIOUS DISEASE & INTERNAL MEDICINE S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANDREONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-288-6215
Mailing Address - Street 1:1426 W IRVING PARK RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-5699
Mailing Address - Country:US
Mailing Address - Phone:708-361-5778
Mailing Address - Fax:
Practice Address - Street 1:7804 W COLLEGE DR
Practice Address - Street 2:SUITE 1NW
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1025
Practice Address - Country:US
Practice Address - Phone:708-361-5778
Practice Address - Fax:708-361-5631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14600OtherADVOCATE CHRIST ID
ILDA4768OtherRAILROAD MEDICARE
IL21622441OtherBCBS PROVIDER ID
ILCI5956OtherRAILROAD MEDICARE
IL14605OtherADVOCATE HLTH PARTNERS
IL602232600OtherUS DEPT OF LABOR
ILDA4748OtherRAILROAD MEDICARE
IL21622441OtherBCBS PROVIDER ID
IL779410Medicare PIN
ILDA4768Medicare PIN
IL14600OtherADVOCATE CHRIST ID
IL602232600OtherUS DEPT OF LABOR