Provider Demographics
NPI:1588694343
Name:MAY, PERCY CONRAD II (MD)
Entity type:Individual
Prefix:DR
First Name:PERCY
Middle Name:CONRAD
Last Name:MAY
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CONRAD
Other - Middle Name:
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1030 N STATE ST
Mailing Address - Street 2:50H
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-5476
Mailing Address - Country:US
Mailing Address - Phone:312-787-3657
Mailing Address - Fax:312-787-8341
Practice Address - Street 1:3857 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-2342
Practice Address - Country:US
Practice Address - Phone:773-533-1417
Practice Address - Fax:773-533-7348
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-038263207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD12107Medicare UPIN
ILK44370Medicare PIN