Provider Demographics
NPI:1821028150
Name:FLAHERTY, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:FLAHERTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:680 N LAKE SHORE DR
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4546
Mailing Address - Country:US
Mailing Address - Phone:312-926-8358
Mailing Address - Fax:312-926-9630
Practice Address - Street 1:676 N SAINT CLAIR ST
Practice Address - Street 2:SUITE 940
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2927
Practice Address - Country:US
Practice Address - Phone:312-926-8358
Practice Address - Fax:312-926-9630
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2014-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036073534207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
E24528Medicare UPIN