Theodore Rexford Addai in Decatur - Cardiovascular Disease
Theodore Rexford Addai - NPI 1912985185
Theodore Rexford Addai is a Cardiovascular Disease in Decatur, Illinois. Theodore Rexford Addai practices all healthcare services and medical treatments related to Cardiovascular Disease. The NPI Number for Theodore Rexford Addai is 1912985185. The last update date is 2021-12-20.
Theodore Rexford Addai's current location address is 1770 E Lake Shore Dr Ste 105, Decatur, Illinois. You can contact this provider via phone number 2174226100 and fax number 8337845326. The mailing address for Theodore Rexford Addai is 1770 E Lake Shore Dr Ste 105, Decatur, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Theodore Rexford Addai |
|---|---|
| Address | 1770 E Lake Shore Dr Ste 105, Decatur, Illinois |
| Phone Number | 2174226100 |
| Fax Number | 8337845326 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1912985185 |
|---|---|
| Provider Enumeration Date | 2006-01-06 |
| Last Updated Date | 2021-12-20 |
Provider Mailing Address Detail
| Address | 1770 E Lake Shore Dr Ste 105 |
|---|---|
| City | Decatur |
| State | Illinois (IL) |
| Post Code | 625213800 |
| Phone Number | 2174226100 |
| Fax Number | 8337845326 |
Provider's Primary Taxonomy Detail
| Speciality | Cardiovascular Disease |
|---|---|
| Taxonomy | 207Rc0000X |
| Licence No | 36078026 |
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Definition: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 334245 | IL | RAILROAD | |
| 36078026 | IL | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Theodore Rexford Addai by the Centers for Medicare & Medicaid Services?
The Theodore Rexford Addai has been issued the NPI (National Provider Identifier) 1912985185, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Theodore Rexford Addai's physical address?
The Theodore Rexford Addai is physically located at 1770 E Lake Shore Dr Ste 105, in the city of Decatur, IL, with the postal code 625213800.
What is the Theodore Rexford Addai's area of specialization and corresponding taxonomy classification?
The Theodore Rexford Addai's specialty field is Cardiovascular Disease, and it falls under the taxonomy code 207Rc0000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1912985185 to Theodore Rexford Addai?
The Theodore Rexford Addai received its 1912985185 assignment from the Centers for Medicare & Medicaid Services on 2006-01-06.
As of what date were the details pertaining to Theodore Rexford Addai last refreshed?
The information related to the Theodore Rexford Addai, including its address, specialty, and other relevant details, was last updated on 2021-12-20.