Provider Demographics
NPI:1508943754
Name:MIDWEST ASSOCIATES IN NEUROLOGY LTD
Entity Type:Organization
Organization Name:MIDWEST ASSOCIATES IN NEUROLOGY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:D
Authorized Official - Last Name:KOHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-524-2440
Mailing Address - Street 1:777 OAKMONT LN
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5511
Mailing Address - Country:US
Mailing Address - Phone:630-789-2550
Mailing Address - Fax:
Practice Address - Street 1:1 ERIE CT
Practice Address - Street 2:SUITE 7020
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2566
Practice Address - Country:US
Practice Address - Phone:708-524-2440
Practice Address - Fax:708-524-2463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01633648OtherBCBS PROVIDER ID
ILCJ9863OtherRAILROAD MEDICARE
ILCJ9863Medicare PIN
IL201892Medicare PIN