David R Edelstein MD SC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036-047656 Issued in IL

Legal business name

DAVID R EDELSTEIN MD SC

Practice address

1917 Westleigh Dr
Glenview, IL 60025-7612

Phone

(312) 332-3699

Fax

(312) 332-3698

NPI assigned

Jul 14, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David R. Edelstein, M.D.

Title

President

Phone

(312) 332-3699

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1144229865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 501",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023402",
            "telephone_number": "312-332-3699",
            "fax_number": "312-332-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 WESTLEIGH DR",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257612",
            "telephone_number": "312-332-3699",
            "fax_number": "312-332-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID R EDELSTEIN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "EDELSTEIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-332-3699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-047656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ILLINOIS",
            "identifier": "21606223",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Glenview, IL
• Providers in Glenview, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.