Provider Demographics
NPI:1083841308
Name:ALAN J. CAMIN, M.D.S.C.
Entity Type:Organization
Organization Name:ALAN J. CAMIN, M.D.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-677-0550
Mailing Address - Street 1:9669 KENTON AVE
Mailing Address - Street 2:STE. 602
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1266
Mailing Address - Country:US
Mailing Address - Phone:847-677-0550
Mailing Address - Fax:847-674-4377
Practice Address - Street 1:9669 KENTON AVE
Practice Address - Street 2:STE. 602
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1266
Practice Address - Country:US
Practice Address - Phone:847-677-0550
Practice Address - Fax:847-674-4377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036036785207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty