Healthcare Provider Details

I. General information

NPI: 1578654075
Provider Name (Legal Business Name): CHICAGO VOICE & SWALLOWING CENTERS, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 11/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W HARRISON ST SUITE 321
CHICAGO IL
60612-3841
US

IV. Provider business mailing address

PO BOX 156
NORTHBROOK IL
60065-0156
US

V. Phone/Fax

Practice location:
  • Phone: 224-436-5420
  • Fax: 847-291-6587
Mailing address:
  • Phone: 224-436-5420
  • Fax: 847-291-6587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number036084409
License Number StateIL

VIII. Authorized Official

Name: DR. STEVEN J CHAROUS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 847-729-9122