Provider Demographics
NPI:1003270398
Name:BURSTEIN, DAVID SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTT
Last Name:BURSTEIN
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 1:750 N LAKE SHORE DR FL 10TH
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4550
Mailing Address - Country:US
Mailing Address - Phone:312-503-6400
Mailing Address - Fax:312-503-2755
Practice Address - Street 1:750 N LAKE SHORE DR FL 10TH
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4550
Practice Address - Country:US
Practice Address - Phone:312-503-6400
Practice Address - Fax:312-503-2755
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-148601207R00000X
DC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty