Theodore Balsam (NPI# 1457384208, PAC ID# 6204899495) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1457384208 |
| PAC ID by PECOS | 6204899495 |
| Professional Enrollment ID | I20041109000386 |
| Full Name | Theodore Balsam |
| Organization Legal Name | VHS ACQUISITION SUBSIDIARY NUMBER 3 INC |
| Address |
4646 N Marine Dr A Suite 4600 Chicago IL 60640-5759 |
| Phone Number | 7735647405 |
| Gender | M |
| Credential | MD |
| Medical School | CHICAGO COLLEGE OF MEDICINE AND SURGERY |
| Graduation Year | 1957 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 4082522842 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140082 | LOUIS A WEISS MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4646 N Marine Dr A, Suite 4600, Chicago, IL 60640-5759 | 7735647405 | VHS ACQUISITION SUBSIDIARY NUMBER 3 INC |
| 4646 N Marine Dr A, Chicago, IL 60640-5759 | 7735647405 | VHS ACQUISITION SUBSIDIARY NUMBER 3 INC |
| Organization Legal Name | VHS ACQUISITION SUBSIDIARY NUMBER 3 INC |
| Physicians | 1 |
| Street Address |
4646 N MARINE DR A SUITE 4600 |
| City | CHICAGO |
| State | IL |
| Zip | 60640-5759 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elaine A Sachnoff | Psychologist, Clinical | 4840 N Marine Dr, Chicago, IL 60640-1067 | |
| Stacey L Knowles | Physical Therapy | 1830 W Foster Ave, Suite Cw, Chicago, IL 60640-1087 | |
| Carolyn A Mildner | Psychologist, Clinical | 1645 W Gregory St, Chicago, IL 60640-1161 | |
| Ridhi Patel | Optometry | Myeyedr Optometry of Illinois LLC | 5408 N Clark St, Chicago, IL 60640-1210 |
| Scott Michael Amoruso | Optometry | Myeyedr Optometry of Illinois LLC | 5408 N Clark St, Chicago, IL 60640-1210 |
| Ellen R Kozob | Optometry | Myeyedr. Optometry of Illinois, LLC | 5408 N Clark St, Chicago, IL 60640-1210 |
| Stacie M Hauenstein | Physical Therapy | Athletico Ltd | 5545 N Clark St, Chicago, IL 60640-1222 |
| Ing Swenson | Clinical Social Worker | Chicago Mindful Psychotherapy, Inc. | 5537 N Clark St, Suite 1, Chicago, IL 60640-1222 |
| Stephen J Hooley | Physical Therapy | Athletico Ltd | 5545 N Clark St, Chicago, IL 60640-1222 |
| Oliver N Beirne | Physical Therapy | Athletico Ltd | 5545 N Clark St, Chicago, IL 60640-1222 |
| Find all physicians in zip 60640 | |||
| City | CHICAGO |
| Zip Code | 60640 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | CHICAGO + INTERNAL MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.