Healthcare Provider Details

I. General information

NPI: 1427912377
Provider Name (Legal Business Name): QUANTUM CLINICS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 N DUSABLE LAKESHORE DR APT 2301
CHICAGO IL
60611
US

IV. Provider business mailing address

505 N DUSABLE LAKESHORE DR APT 2301
CHICAGO IL
60611
US

V. Phone/Fax

Practice location:
  • Phone: 219-793-3339
  • Fax:
Mailing address:
  • Phone: 219-793-3339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224L00000X
TaxonomyPedorthist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name: VIKRAM CHOUDHARY
Title or Position: PRESIDENT/ OWNER
Credential:
Phone: 219-793-3339