Provider Demographics
NPI:1902824113
Name:BELSKY, CORINNE JUDITH (MD)
Entity Type:Individual
Prefix:DR
First Name:CORINNE
Middle Name:JUDITH
Last Name:BELSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:JUDITH
Other - Last Name:BLACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3001 GREEN BAY RD
Mailing Address - Street 2:133-EF
Mailing Address - City:NORTH CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60064-3048
Mailing Address - Country:US
Mailing Address - Phone:224-610-5940
Mailing Address - Fax:224-610-8656
Practice Address - Street 1:3001 GREEN BAY RD
Practice Address - Street 2:133-EF
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-3048
Practice Address - Country:US
Practice Address - Phone:224-610-5940
Practice Address - Fax:224-610-8656
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005010812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC142C3OtherBCBS-IND.
NC5902810Medicaid
NC5902810Medicaid
NC142C3OtherBCBS-IND.