Provider Demographics
NPI:1093951469
Name:NORMAN J MARKUS M.D. S.C.
Entity Type:Organization
Organization Name:NORMAN J MARKUS M.D. S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARKUS
Authorized Official - Suffix:
Authorized Official - Credentials:MDSC
Authorized Official - Phone:847-432-8180
Mailing Address - Street 1:767 PARK AVE W
Mailing Address - Street 2:180
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2400
Mailing Address - Country:US
Mailing Address - Phone:847-432-8180
Mailing Address - Fax:847-432-8479
Practice Address - Street 1:767 PARK AVE W
Practice Address - Street 2:180
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2400
Practice Address - Country:US
Practice Address - Phone:847-432-8180
Practice Address - Fax:847-432-8479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
619350Medicare PIN
ILD13593Medicare UPIN
IL619350Medicare PIN