Provider Demographics
NPI:1740217041
Name:SWINER, CONNIE III (MD)
Entity Type:Individual
Prefix:DR
First Name:CONNIE
Middle Name:
Last Name:SWINER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CONNIE
Other - Middle Name:
Other - Last Name:SWINER
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1501 S INDIANA AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3347
Mailing Address - Country:US
Mailing Address - Phone:312-945-3837
Mailing Address - Fax:
Practice Address - Street 1:500 E 51ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-2400
Practice Address - Country:US
Practice Address - Phone:312-572-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology