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General NPI Number Information
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NPI Number | 1285603928
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Entity Type | Organization
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Legal Business Name | CHICAGO ORTHOPAEDIC & SPORTS MEDICINE SC
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 10/07/2015
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Provider Practice Location Address
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Address Line | 3000 N HALSTED ST SUITE 525
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City | CHICAGO
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State | IL
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Zip | 60657
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Country | US
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Telephone | 773-433-3130
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Fax | 773-433-3125
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Provider Business Mailing Address
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Address Line | 3000 N HALSTED ST #525
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City | CHICAGO
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State | IL
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Zip | 60657-5188
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Country | US
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Telephone | 773-433-3130
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Fax | 773-433-3125
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID GUELICH
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Credential | MD
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Telephone | 773-433-3130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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