Provider Demographics
NPI:1467510883
Name:COLEMAN R SESKIND MD SC
Entity Type:Organization
Organization Name:COLEMAN R SESKIND MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-726-7595
Mailing Address - Street 1:100 E HURON STREET
Mailing Address - Street 2:SUITE 1704
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5900
Mailing Address - Country:US
Mailing Address - Phone:312-664-1666
Mailing Address - Fax:312-664-6887
Practice Address - Street 1:100 E HURON STREET
Practice Address - Street 2:SUITE 1704
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5900
Practice Address - Country:US
Practice Address - Phone:312-664-1666
Practice Address - Fax:312-664-6887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3637930207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36037930Medicaid
IL1604975OtherBLUE CROSS BLUE SHIELD
IL425790Medicare PIN
C40473Medicare UPIN