Provider Demographics
NPI:1255313367
Name:ADLER, DOUGLAS R (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:R
Last Name:ADLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 COMPASS RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8000
Mailing Address - Country:US
Mailing Address - Phone:847-677-1170
Mailing Address - Fax:847-677-1233
Practice Address - Street 1:2501 COMPASS RD
Practice Address - Street 2:SUITE 130
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8000
Practice Address - Country:US
Practice Address - Phone:847-677-1170
Practice Address - Fax:847-677-1233
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036060472207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036060472Medicaid
100003875OtherMEDICARE RAILROAD
IL036060472Medicaid
IL036060472Medicaid