Provider Demographics
NPI:1073769287
Name:YOUNG, ADAM C (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:C
Last Name:YOUNG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1653 W CONGRESS PKWY
Mailing Address - Street 2:739 JELKE
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3833
Mailing Address - Country:US
Mailing Address - Phone:312-942-5000
Mailing Address - Fax:312-942-8858
Practice Address - Street 1:1653 W CONGRESS PKWY
Practice Address - Street 2:739 JELKE
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3833
Practice Address - Country:US
Practice Address - Phone:312-942-5000
Practice Address - Fax:312-942-8858
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2014-08-11
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Provider Licenses
StateLicense IDTaxonomies
IL036128855207L00000X, 208VP0014X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL646410013Medicare PIN