Basic Information
| Provider Information | |||||||||
| NPI: | 1346406253 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CONNERS | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 710 N LAKE SHORE DR | ||||||||
| Address2: | ABBOTT HALL, 11TH FLOOR | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606113006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129088266 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1725 W HARRISON ST | ||||||||
| Address2: | SUITE 118 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606123841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129424500 | ||||||||
| FaxNumber: | 3129422380 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2008 | ||||||||
| LastUpdateDate: | 06/04/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 036120013 | IL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 036120013 | 01 | IL | ILLINOIS PERMANENT PHYSICIAN NUMBER | OTHER |