Healthcare Provider Details

I. General information

NPI: 1083635221
Provider Name (Legal Business Name): BONE AND JOINT CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 N CICERO AVE SUITE 200
CHICAGO IL
60641-1651
US

IV. Provider business mailing address

4211 N CICERO AVE SUITE 200
CHICAGO IL
60641-1651
US

V. Phone/Fax

Practice location:
  • Phone: 773-545-6900
  • Fax: 773-545-2220
Mailing address:
  • Phone: 773-545-6900
  • Fax: 773-545-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. SARMED G. ELIAS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 773-545-6900