Provider Demographics
NPI:1992730030
Name:SY, HAROLD MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:MICHAEL
Last Name:SY
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 1:5086 N ELSTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2427
Mailing Address - Country:US
Mailing Address - Phone:773-282-2000
Mailing Address - Fax:
Practice Address - Street 1:5086 N ELSTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2427
Practice Address - Country:US
Practice Address - Phone:773-282-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036113980207WX0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA058020OtherMEDICAL LICENSE
GA936953955AMedicaid
GA18BDGQZMedicare ID - Type Unspecified