Provider Demographics
NPI:1669455549
Name:CAREY B DACHMAN MDSC
Entity Type:Organization
Organization Name:CAREY B DACHMAN MDSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:B
Authorized Official - Last Name:DACHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-352-5511
Mailing Address - Street 1:455 S ROSELLE RD
Mailing Address - Street 2:STE 104
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-2971
Mailing Address - Country:US
Mailing Address - Phone:847-352-5511
Mailing Address - Fax:847-352-0814
Practice Address - Street 1:455 S ROSELLE RD
Practice Address - Street 2:#104
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-2971
Practice Address - Country:US
Practice Address - Phone:847-352-5511
Practice Address - Fax:847-352-0814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RR0500X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL354650Medicare ID - Type Unspecified