Provider Demographics
NPI:1447450788
Name:SUR, JAMES PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PAUL
Last Name:SUR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13011 S 104TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-1508
Mailing Address - Country:US
Mailing Address - Phone:708-478-3600
Mailing Address - Fax:708-478-3552
Practice Address - Street 1:11560 S KEDZIE AVE STE 100
Practice Address - Street 2:
Practice Address - City:MERRIONETTE PARK
Practice Address - State:IL
Practice Address - Zip Code:60803-4517
Practice Address - Country:US
Practice Address - Phone:708-824-1114
Practice Address - Fax:708-824-9341
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2021-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036112473207R00000X, 207RC0000X, 207RI0011X
IL042007998207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease