Provider Demographics
NPI:1790734069
Name:POLLAK, ALAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:C
Last Name:POLLAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9150 CRAWFORD AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1700
Mailing Address - Country:US
Mailing Address - Phone:847-679-1605
Mailing Address - Fax:
Practice Address - Street 1:9150 CRAWFORD AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1700
Practice Address - Country:US
Practice Address - Phone:847-679-1605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0336-043468207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL326010Medicare ID - Type Unspecified
ILF55565Medicare UPIN