Basic Information
Provider Information
NPI: 1972128445
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: UNLU
FirstName: BEKIR
MiddleName: SERDAR
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1930 S MORGAN ST # 2
Address2:  
City: CHICAGO
State: IL
PostalCode: 606083403
CountryCode: US
TelephoneNumber: 2814501743
FaxNumber:  
Practice Location
Address1: 1500 S FAIRFIELD AVE
Address2:  
City: CHICAGO
State: IL
PostalCode: 606081782
CountryCode: US
TelephoneNumber: 7735422000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/10/2020
LastUpdateDate: 06/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X125.076716ILY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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