MEDICARE: BONE AND JOINT CENTER PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CL7036	OTHER	IL	MEDICARE RAILROAD

General Provider Information

NPI Number	:	1083635221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BONE AND JOINT CENTER PC

Provider Business Mailing Address
First Line	:	4211 N CICERO AVE
Second Line	:	SUITE 200
City	:	CHICAGO
State	:	IL
Zip	:	60641-1651
Country	:	US
Telephone Number	:	773-545-6900
Fax Number	:	773-545-2220

Provider Business Practice Location Address
First Line	:	4211 N CICERO AVE
Second Line	:	SUITE 200
City	:	CHICAGO
State	:	IL
Zip	:	60641-1651
Country	:	US
Telephone Number	:	773-545-6900
Fax Number	:	773-545-2220

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SARMED G. ELIAS
Credential	:	M.D.
Telephone Number	:	773-545-6900

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	06/12/2008

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Directions to “BONE AND JOINT CENTER PC ” Practice Location

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