Ethan Michael Meisel
Emergency Physician General Practice Physician
211 E Ontario St Suite 925
Chicago
, Illinois 60611-3468
Ethan Michael Meisel
Emergency Physician General Practice Physician
211 E Ontario St Suite 925
Chicago
, Illinois 60611-3468
(877) 489-5993
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About
Features
Specialties
- Emergency Physician
- General Practice Physician
Languages spoken
- English
Location
First Address
- Ethan Michael Meisel
- 2001 Butterfield Rd Suite 300
- Downers Grove, IL
- Zip : 60515-1050
- Fax : (877) 489-5993
- Phone : (630) 725-2832
Second Address
- Ethan Michael Meisel
- 211 E Ontario St Suite 925
- Chicago, IL
- Zip : 60611-3468
- Fax : (312) 573-0694
- Phone : (312) 573-0614
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207P00000X | Emergency Physician | H95343 | GA |
| Y | 208D00000X | General Practice Physician | 036.123753 | IL |
National Provider Identifier
| NPI | 1013029511 |
|---|---|
| Provider Name | Ethan Michael Meisel |
| First Address | Downers Grove, IL 60515-1050 |
| Second Address | Chicago, IL 60611-3468 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/08/2006 |
| Last Update Date | 20/05/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 171006162A | (05) | GA |
| 171006162B | (05) | GA |
| H95343 | (02) | CA |
| P01186845 | MEDICARE RAILROAD INDIVIDUAL PTAN (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.