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General NPI Number Information
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NPI Number | 1104066398
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Entity Type | Organization
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Legal Business Name | CENTRAL MEDICAL SPECIALISTS LLC
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Dates
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Enumeration Date | 02/27/2009
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Last Update Date | 09/28/2012
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Provider Practice Location Address
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Address Line | 2715 N CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60639-1351
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Country | US
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Telephone | 312-326-6100
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Fax | 773-385-6890
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Provider Business Mailing Address
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Address Line | 2715 N CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60639-1351
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Country | US
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Telephone | 312-326-6100
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Fax | 773-385-6890
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. JOHN J OKEEFE
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Credential | M.D.
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Telephone | 312-326-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | IL
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