Provider Demographics
NPI:1740302165
Name:PAUL GETZ, M.D., S.C.
Entity type:Organization
Organization Name:PAUL GETZ, M.D., S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR & PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GETZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-851-8888
Mailing Address - Street 1:1201 WATER TOWER RD
Mailing Address - Street 2:
Mailing Address - City:WEST DUNDEE
Mailing Address - State:IL
Mailing Address - Zip Code:60118-3330
Mailing Address - Country:US
Mailing Address - Phone:847-851-8888
Mailing Address - Fax:847-851-8889
Practice Address - Street 1:1201 WATER TOWER RD
Practice Address - Street 2:
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-3330
Practice Address - Country:US
Practice Address - Phone:847-851-8888
Practice Address - Fax:847-851-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1508866443Medicare ID - Type UnspecifiedPHYSICIAN