DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: HYDE PARK MEDICAL SPECIALTY GROUP, LLC

MEDICARE: HYDE PARK MEDICAL SPECIALTY GROUP, LLC
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
1207R00000XInternal Medicine PhysicianIL
2207L00000XAnesthesiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101633434OTHERILBCBS

General Provider Information

NPI Number : 1588656037
Entity Type Code : Organization
Provider Name (Legal Business Name) : HYDE PARK MEDICAL SPECIALTY GROUP, LLC
Provider Business Mailing Address
First Line : 9933 S WESTERN AVE
Second Line : SUITE 102
City : CHICAGO
State : IL
Zip : 60643-1810
Country : US
Telephone Number : 773-233-3800
Fax Number : 773-233-2513
Provider Business Practice Location Address
First Line : 1644 E 53RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4210
Country : US
Telephone Number : 773-752-2111
Fax Number : 773-752-6703
Authorized Official
Title or Position : MEDICAL DIRECTOR/CEO
Name : MRS. FORTUNEE MASSUDA
Credential : DPM
Telephone Number : 773-752-2111
Provider Enumeration Date : 08/19/2005
Last Update Date : 07/19/2012

Similar Medicare Providers

1952307019 — FORTUNEE MASSUDA DPM
Practice Location Address:
1644 E 53RD ST
CHICAGO, IL
60615-4210
Practice Phone: 773-752-2111
Practice Fax: 773-752-6703
1447242862 — HYDE PARK PODIATRY CTR LTD
Practice Location Address:
1644 E 53RD ST
CHICAGO, IL
60615-4210
Practice Phone: 773-752-2111
Practice Fax: 773-233-6703
1609868041 — HYDE PARK SURGERY CENTER, LLC
Practice Location Address:
1644 E 53RD ST
CHICAGO, IL
60615-4210
Practice Phone: 773-752-2111
Practice Fax: 773-752-6703
1255423372 — THOMAS MACNEILL-ZIMMERMAN D.C.
Practice Location Address:
1644 E 53RD ST , SUITE A
CHICAGO, IL
60615-4210
Practice Phone: 773-322-1123
Practice Fax: 773-322-1126
1437291242 — JOSE SEGURA MPT
Practice Location Address:
1644 E 53RD ST
CHICAGO, IL
60615-4210
Practice Phone: 773-241-6450
Practice Fax: 773-241-6501
1598907669 — ATHLETICO, LTD
Practice Location Address:
1644 E 53RD ST
CHICAGO, IL
60615-4210
Practice Phone: 773-241-6450
Practice Fax: 773-241-6501

Directions to “HYDE PARK MEDICAL SPECIALTY GROUP, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.