MEDICARE: STEVEN SCLAMBERG MD

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	207X00000X	Orthopaedic Surgery Physician	036104339	IL

General Provider Information

NPI Number	:	1538112255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN SCLAMBERG MD

Provider Business Mailing Address
First Line	:	4709 GOLF RD
Second Line	:	SUITE 1200
City	:	SKOKIE
State	:	IL
Zip	:	60076-1231
Country	:	US
Telephone Number	:	847-869-7233
Fax Number	:	847-869-9416

Provider Business Practice Location Address
First Line	:	4709 GOLF RD
Second Line	:	SUITE 1200
City	:	SKOKIE
State	:	IL
Zip	:	60076-1231
Country	:	US
Telephone Number	:	847-869-7233
Fax Number	:	847-869-9416

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	11/25/2014

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