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General NPI Number Information
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NPI Number | 1750633061
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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 | 10/10/2012
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Last Update Date | 11/09/2012
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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 | BILLING AND COLLECTIONS MANAGER
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Name | MR. SEAN THOMAS OKEEFE
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Credential |
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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 | IL
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