Healthcare Provider Details

I. General information

NPI: 1679781355
Provider Name (Legal Business Name): ORTHOPAEDIC AND REHABILITATION CENTERS SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5616 N WESTERN AVE
CHICAGO IL
60659-5113
US

IV. Provider business mailing address

5616 N WESTERN AVE
CHICAGO IL
60659-5113
US

V. Phone/Fax

Practice location:
  • Phone: 773-878-6233
  • Fax: 773-878-2688
Mailing address:
  • Phone: 773-878-6233
  • Fax: 773-878-2688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. ROBERTO E LEVI
Title or Position: PHYSICIAN
Credential: MD
Phone: 773-878-6233