Healthcare Provider Details

I. General information

NPI: 1629825294
Provider Name (Legal Business Name): SCHUBERT SURGICAL SERVICES SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2024
Last Update Date: 09/02/2025
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 W DIVISION ST STE 235
CHICAGO IL
60622-2989
US

IV. Provider business mailing address

1S376 SUMMIT AVE STE 4C
OAKBROOK TERRACE IL
60181-3966
US

V. Phone/Fax

Practice location:
  • Phone: 708-453-6800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES BRADLEY SCHUBERT
Title or Position: OWNER
Credential: MD
Phone: 708-453-6800