Provider Demographics
NPI:1487610788
Name:RING, ALVIN M (MD)
Entity type:Individual
Prefix:
First Name:ALVIN
Middle Name:M
Last Name:RING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAYMOOR LN
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1213
Mailing Address - Country:US
Mailing Address - Phone:815-740-7073
Mailing Address - Fax:815-740-4966
Practice Address - Street 1:1900 SILVER CROSS BLVD
Practice Address - Street 2:SILVER CROSS HOSPITAL
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-9509
Practice Address - Country:US
Practice Address - Phone:815-300-7073
Practice Address - Fax:815-300-4966
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-040127207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
220005352OtherRR MC
IL036040127-3Medicaid
L09306Medicare ID - Type Unspecified
IL036040127-3Medicaid