Basic Information
Provider Information
NPI: 1447260609
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GINSBURG
FirstName: DAVID
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 767 PARK AVE W
Address2: SUITE 260
City: HIGHLAND PARK
State: IL
PostalCode: 600352400
CountryCode: US
TelephoneNumber: 8474327222
FaxNumber: 8474329360
Practice Location
Address1: 767 PARK AVE W
Address2: SUITE 260
City: HIGHLAND PARK
State: IL
PostalCode: 600352400
CountryCode: US
TelephoneNumber: 8474327222
FaxNumber: 8474329360
Other Information
ProviderEnumerationDate: 08/09/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300X ILY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


Home