Healthcare Provider Details

I. General information

NPI: 1831045426
Provider Name (Legal Business Name): SOUTH SUBURBAN INJURY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5669 W 95TH ST UNIT 4
OAK LAWN IL
60453-2382
US

IV. Provider business mailing address

5669 W 95TH ST UNIT 4
OAK LAWN IL
60453-2382
US

V. Phone/Fax

Practice location:
  • Phone: 708-513-7744
  • Fax: 708-221-8500
Mailing address:
  • Phone: 708-513-7744
  • Fax: 708-221-8500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MAX LAZAROWICH
Title or Position: PRESIDENT
Credential: DC
Phone: 773-316-5786