Provider Demographics
NPI:1497896500
Name:PTASINSKI, JOSEPH CYRUS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CYRUS
Last Name:PTASINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2110 HONEY LOCUST DR
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-5001
Mailing Address - Country:US
Mailing Address - Phone:708-337-0472
Mailing Address - Fax:847-458-6133
Practice Address - Street 1:1555 BARRINGTON RD
Practice Address - Street 2:SUITE 335
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60194-1019
Practice Address - Country:US
Practice Address - Phone:708-337-0472
Practice Address - Fax:847-458-6133
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0306049251Medicaid
IL0306049251Medicaid
ILC41040Medicare UPIN