Provider Demographics
NPI:1265667158
Name:WILLIAM MARKEY MD,SC
Entity Type:Organization
Organization Name:WILLIAM MARKEY MD,SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLAIM
Authorized Official - Middle Name:SIMON
Authorized Official - Last Name:MARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-944-2188
Mailing Address - Street 1:PO BOX 146530
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6400
Mailing Address - Country:US
Mailing Address - Phone:312-944-2188
Mailing Address - Fax:
Practice Address - Street 1:3000 N HALSTED ST STE 506
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5194
Practice Address - Country:US
Practice Address - Phone:312-944-2188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036046023207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036046023Medicaid
ILC45070Medicare UPIN