Provider Demographics
NPI:1093025025
Name:STEVEN J RESIS MD SC
Entity Type:Organization
Organization Name:STEVEN J RESIS MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RESIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, SC
Authorized Official - Phone:847-240-2211
Mailing Address - Street 1:1701 E. WOODFIELD ROAD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5113
Mailing Address - Country:US
Mailing Address - Phone:847-240-2211
Mailing Address - Fax:847-240-2418
Practice Address - Street 1:1701 E. WOODFIELD ROAD
Practice Address - Street 2:SUITE 1000
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5113
Practice Address - Country:US
Practice Address - Phone:847-240-2211
Practice Address - Fax:847-240-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0757832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL923350OtherMEDICARE
ILC40808Medicare UPIN