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General NPI Number Information
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NPI Number | 1285084046
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Entity Type | Organization
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Legal Business Name | SOUTH CHICAGO ORTHOPEDIC SPECIALISTS, SC
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Dates
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Enumeration Date | 06/13/2016
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 1701 W MONTEREY AVE STE 4
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City | CHICAGO
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State | IL
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Zip | 60643-4257
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Country | US
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Telephone | 872-228-0235
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Fax | 773-530-0520
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Provider Business Mailing Address
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Address Line | 1701 W MONTEREY AVE STE 4
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City | CHICAGO
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State | IL
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Zip | 60643-4257
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Country | US
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Telephone | 872-228-0235
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Fax | 773-530-0520
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Authorized Official
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Title or Position | PHYSICIAN
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Name | STEVEN ARTHUR CHANDLER
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Credential | D.O.
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Telephone | 872-228-0235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 036118743
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License Number State | IL
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