Forman, Edward
Forman, Edward is an sole proprietor health care provider with primary practice located at 4801 W Peterson Ave Ste 606 , Chicago IL 60646-5728. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Forman, Edward can be contacted via phone (773) 829-4700.Contact Information
Primary practice address
4801 W Peterson Ave Ste 606
Chicago IL 60646-5728
Phone: (773) 829-4700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 036-095583 | Illinois |
Profile Details
| NPI number | 1639122955 |
|---|---|
| LBN Legal business name | Forman, Edward |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 18th, 2006 |
| Last updated | Feb 19th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639122955 | NPPES |
| Illinois | MEDICAID | 036-095583 |
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