Provider Demographics
NPI:1134347305
Name:SCHIRMANG, TODD CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:CHRISTOPHER
Last Name:SCHIRMANG
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 1:4062 DEPARTMENT
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60122-4062
Mailing Address - Country:US
Mailing Address - Phone:888-653-7107
Mailing Address - Fax:706-653-1230
Practice Address - Street 1:5145 N CALIFORNIA AVE
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3661
Practice Address - Country:US
Practice Address - Phone:773-989-6222
Practice Address - Fax:706-653-1230
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1411132085R0202X
IL0361251242085R0202X, 2085R0204X
IL036-1251242085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036125124Medicaid
IL202926OtherGROUP PTAN
IL202926018OtherINDIVIDUAL PTAN
IL212545OtherGROUP PTAN
IL212545025OtherINDIVIDUAL PTAN