Provider Demographics
NPI:1407845019
Name:PULMONARY AND CRITICAL CARE CONSULTANTS, S.C.
Entity Type:Organization
Organization Name:PULMONARY AND CRITICAL CARE CONSULTANTS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTANAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:RAZMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-274-4900
Mailing Address - Street 1:700 E OGDEN AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5554
Mailing Address - Country:US
Mailing Address - Phone:866-871-5737
Mailing Address - Fax:630-522-0843
Practice Address - Street 1:11900 SOUTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-1200
Practice Address - Country:US
Practice Address - Phone:708-274-4900
Practice Address - Fax:708-274-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RC0200X, 207RP1001X
IL207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31601608OtherBCBS IL GROUP #
ILCF4228OtherMEDICARE RAILROAD
ILCF4228OtherMEDICARE RAILROAD
IL110115370OtherMEDICARE RAILROAD
IL910750Medicare PIN