Provider Demographics
NPI:1689866337
Name:HOWARD N. TUSHMAN, M.D., S.C.
Entity Type:Organization
Organization Name:HOWARD N. TUSHMAN, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:TUSHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-869-6011
Mailing Address - Street 1:2530 RIDGE AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2492
Mailing Address - Country:US
Mailing Address - Phone:847-869-6011
Mailing Address - Fax:847-869-6075
Practice Address - Street 1:2530 RIDGE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-2492
Practice Address - Country:US
Practice Address - Phone:847-869-6011
Practice Address - Fax:847-869-6075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty