Provider Demographics
NPI:1912911355
Name:SOUTHWEST RESPIRATORY CONSULTANTS SC
Entity Type:Organization
Organization Name:SOUTHWEST RESPIRATORY CONSULTANTS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MCELLIGOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-355-8776
Mailing Address - Street 1:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-0379
Mailing Address - Country:US
Mailing Address - Phone:708-460-9836
Mailing Address - Fax:708-460-1117
Practice Address - Street 1:100 SPALDING DR
Practice Address - Street 2:SUITE 200
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6550
Practice Address - Country:US
Practice Address - Phone:630-355-8776
Practice Address - Fax:630-355-7445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1616235OtherBCBS IL
IL36068795Medicaid
IL36057895Medicaid
IL36068795Medicaid
ILK09163Medicare UPIN
ILK09162Medicare UPIN
ILK09164Medicare UPIN