MEDICARE: ARTHRITIS AND AUTOIMMUNE DISEASE CENTER, S.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician		IL

General Provider Information

NPI Number	:	1336470087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARTHRITIS AND AUTOIMMUNE DISEASE CENTER, S.C.

Provider Business Mailing Address
First Line	:	33 W ONTARIO ST
Second Line	:	43EN
City	:	CHICAGO
State	:	IL
Zip	:	60654-7760
Country	:	US
Telephone Number	:	773-913-2585
Fax Number	:

Provider Business Practice Location Address
First Line	:	5106 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3113
Country	:	US
Telephone Number	:	773-913-2585
Fax Number	:	773-904-2955

Authorized Official
Title or Position	:	RHEUMATOLOGIST
Name	:	DR. LAISVYDE SMAJKIC
Credential	:	M.D.
Telephone Number	:	773-913-2585

Provider Enumeration Date	:	01/20/2010
Last Update Date	:	06/08/2010

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