MEDICARE: CHICAGO SURGICAL CLINIC, LTD.

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	208600000X	Surgery Physician	036097501	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	01628326	OTHER		BC/BS

General Provider Information

NPI Number	:	1336174291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGO SURGICAL CLINIC, LTD.

Provider Business Mailing Address
First Line	:	129 W RAND RD STE 2
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3142
Country	:	US
Telephone Number	:	847-215-0530
Fax Number	:	847-818-8640

Provider Business Practice Location Address
First Line	:	129 W RAND RD STE 2
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3142
Country	:	US
Telephone Number	:	847-215-0530
Fax Number	:	847-818-8640

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YELENA LEVITIN
Credential	:	M.D.
Telephone Number	:	847-215-0530

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	05/15/2024

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Directions to “CHICAGO SURGICAL CLINIC, LTD. ” Practice Location

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