Provider Demographics
NPI:1033780325
Name:JOHN STRACKS, MD, LLC
Entity Type:Organization
Organization Name:JOHN STRACKS, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NIRALI
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-489-8890
Mailing Address - Street 1:1828 W WEBSTER AVE STE 450
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-2916
Mailing Address - Country:US
Mailing Address - Phone:312-489-8890
Mailing Address - Fax:
Practice Address - Street 1:1828 W WEBSTER AVE STE 450
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-2916
Practice Address - Country:US
Practice Address - Phone:312-489-8890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty