Provider Demographics
NPI:1821188772
Name:GEORGES, GEORGE EARL (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:EARL
Last Name:GEORGES
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 1:303 E SUPERIOR ST STE 5-105
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3015
Mailing Address - Country:US
Mailing Address - Phone:312-503-1761
Mailing Address - Fax:312-908-5717
Practice Address - Street 1:303 E SUPERIOR ST STE 5-105
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3015
Practice Address - Country:US
Practice Address - Phone:312-503-1761
Practice Address - Fax:312-908-5717
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031922207RH0003X
IL036164047207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0231049OtherL&I
WA1821188772Medicaid
3453OtherINTERNAL ID-MOTOR VEHICLE ID
F58598Medicare UPIN
WAAB10065Medicare PIN