Provider Demographics
NPI:1649331646
Name:NEWMAN, ALAN I (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:I
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6836 S CRANDON AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-1251
Mailing Address - Country:US
Mailing Address - Phone:773-493-8126
Mailing Address - Fax:773-493-8124
Practice Address - Street 1:1229 N NORTH BRANCH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-2473
Practice Address - Country:US
Practice Address - Phone:312-939-5090
Practice Address - Fax:312-640-4496
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2012-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-066944207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E24440Medicare UPIN