Basic Information
| Provider Information | |||||||||
| NPI: | 1821470006 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLYNN | ||||||||
| FirstName: | STEVEN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 651 S WELLS ST | ||||||||
| Address2: | APT#311 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606074508 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 GRANT ST | ||||||||
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| City: | GARY | ||||||||
| State: | IN | ||||||||
| PostalCode: | 464026099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2198864000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2015 | ||||||||
| LastUpdateDate: | 08/27/2019 | ||||||||
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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 | 207P00000X | 01080430A | IN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 125067735 | IL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.