Provider Demographics
NPI:1407935406
Name:CIOS, ADAM T (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:T
Last Name:CIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-5034
Mailing Address - Country:US
Mailing Address - Phone:847-698-5570
Mailing Address - Fax:
Practice Address - Street 1:1234 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5034
Practice Address - Country:US
Practice Address - Phone:847-698-5570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36-089552207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36-089552Medicaid
IL36-089552Medicaid