Provider Demographics
NPI:1457432551
Name:CEDAR-CROSSE RESEARCH CENTER,SC
Entity Type:Organization
Organization Name:CEDAR-CROSSE RESEARCH CENTER,SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:H
Authorized Official - Last Name:SUGIMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-431-6780
Mailing Address - Street 1:800 S .WELLS, ST.
Mailing Address - Street 2:STE M15
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4559
Mailing Address - Country:US
Mailing Address - Phone:312-431-6780
Mailing Address - Fax:312-431-7959
Practice Address - Street 1:800 S WELLS ST STE M15
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4559
Practice Address - Country:US
Practice Address - Phone:312-431-6780
Practice Address - Fax:312-431-7959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036070892207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty