Provider Demographics
NPI:1417038043
Name:DEUTSCH, DAVID D (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:D
Last Name:DEUTSCH
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 1:1215 W LEXINGTON ST
Mailing Address - Street 2:UNIT L
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4169
Mailing Address - Country:US
Mailing Address - Phone:312-666-7180
Mailing Address - Fax:312-666-7237
Practice Address - Street 1:4646 N MARINE DR
Practice Address - Street 2:SUITE B-5000 GYNECOLOGY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5759
Practice Address - Country:US
Practice Address - Phone:773-564-5430
Practice Address - Fax:773-564-5431
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036061403207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D25829Medicare UPIN