Provider Demographics
NPI:1093797987
Name:TSARWHAS, DEAN G (MD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:G
Last Name:TSARWHAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:660 N WESTMORELAND RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1659
Mailing Address - Country:US
Mailing Address - Phone:847-582-2134
Mailing Address - Fax:847-535-7858
Practice Address - Street 1:660 N WESTMORELAND RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1659
Practice Address - Country:US
Practice Address - Phone:847-582-2134
Practice Address - Fax:847-535-7858
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036086008207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036086008Medicaid
ILL98995Medicare PIN
ILL25869Medicare PIN
ILE86721Medicare UPIN
IL110079140Medicare ID - Type UnspecifiedRAILROAD MEDICARE