Provider Demographics
NPI:1992873244
Name:SESKIND, COLEMAN R (MD)
Entity type:Individual
Prefix:
First Name:COLEMAN
Middle Name:R
Last Name:SESKIND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 E HURON
Mailing Address - Street 2:SUITE 1704
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5900
Mailing Address - Country:US
Mailing Address - Phone:312-664-1666
Mailing Address - Fax:312-664-6887
Practice Address - Street 1:333 N MICHIGAN AVE
Practice Address - Street 2:SUITE 701
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601
Practice Address - Country:US
Practice Address - Phone:312-726-7595
Practice Address - Fax:312-726-1054
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2015-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL3637930207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36037930Medicaid
IL1604975OtherBLUE CROSS BLUE SHIELD
ILSE425790Medicare ID - Type Unspecified
IL36037930Medicaid