Provider Demographics
NPI:1750573465
Name:FUNK, ARTHUR DOMINIC (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:DOMINIC
Last Name:FUNK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1335 S PRAIRIE AVE
Mailing Address - Street 2:#403
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3121
Mailing Address - Country:US
Mailing Address - Phone:312-945-3611
Mailing Address - Fax:312-945-3622
Practice Address - Street 1:1335 S PRAIRIE AVE
Practice Address - Street 2:#403
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-3121
Practice Address - Country:US
Practice Address - Phone:312-945-3611
Practice Address - Fax:312-945-3622
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine