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NPI Code Detail

MEDICARE: CURTIS L SPEED MD HEALTH SERVICES SC

MEDICARE: CURTIS L SPEED MD HEALTH SERVICES SC
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
1208000000XPediatrics PhysicianIL

General Provider Information

NPI Number : 1417146689
Entity Type Code : Organization
Provider Name (Legal Business Name) : CURTIS L SPEED MD HEALTH SERVICES SC
Provider Business Mailing Address
First Line : 3601 W 183RD ST
Second Line :
City : HAZEL CREST
State : IL
Zip : 60429-2409
Country : US
Telephone Number : 708-957-7623
Fax Number :
Provider Business Practice Location Address
First Line : 8058 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60620-5936
Country : US
Telephone Number : 773-863-9488
Fax Number :
Authorized Official
Title or Position : CEO
Name : CURTIS L SPEED
Credential : M.D.
Telephone Number : 312-217-1450
Provider Enumeration Date : 10/23/2007
Last Update Date : 10/23/2007

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Directions to “CURTIS L SPEED MD HEALTH SERVICES SC ” Practice Location

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