Provider Demographics
NPI:1821292145
Name:ANTHONY CIRRINCIONE, M.D., S.C.
Entity Type:Organization
Organization Name:ANTHONY CIRRINCIONE, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:CIRRINCIONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-491-6540
Mailing Address - Street 1:2500 RIDGE AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2455
Mailing Address - Country:US
Mailing Address - Phone:847-491-6540
Mailing Address - Fax:847-864-2200
Practice Address - Street 1:2500 RIDGE AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-2455
Practice Address - Country:US
Practice Address - Phone:847-491-6540
Practice Address - Fax:847-864-2200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36063377207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty