Philip H Sheridan Jr SC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

036079226 Issued in IL

Legal business name

PHILIP H SHERIDAN JR SC

Practice address

2650 Ridge Ave
Evanston, IL 60201-1718

Phone

(847) 657-1960

Fax

(847) 446-1893

NPI assigned

Dec 31, 2007

Organization subpart

No

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

Authorized official

Name

Philip H Sheridan Jr., M.D.

Title

President

Phone

(847) 774-7836

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1992980627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 616",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601300616",
            "telephone_number": "708-366-7177",
            "fax_number": "708-366-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-657-1960",
            "fax_number": "847-446-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP H SHERIDAN JR SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "SHERIDAN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-774-7836",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036079226",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036079226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "216062",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01637916",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036079226",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristina Violet Pfeiffer, MD
• Hai Pham, APN-CRNA
• Hillary Pham, PT, DPT
• Ngan Tran Khanh Pham, MD
• Van D Pham, O.D.
• KJ Philip, MD
• Jessica Philipp, CCC-SLP
• Jenny K Philipson, LCSW
• Daniel K. Phillip, PSY.D.
• Amarii Phillips

• Pulmonary Disease Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Pulmonary Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.