MEDICARE: UPTOWN ORTHOPAEDIC SURGEONS 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
1	174400000X	Specialist	036-048615	IL

General Provider Information

NPI Number	:	1669400271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPTOWN ORTHOPAEDIC SURGEONS SC

Provider Business Mailing Address
First Line	:	1945 W WILSON AVE
Second Line	:	SUITE # 6116-18
City	:	CHICAGO
State	:	IL
Zip	:	60640-5255
Country	:	US
Telephone Number	:	773-275-5176
Fax Number	:	773-275-1130

Provider Business Practice Location Address
First Line	:	1945 W WILSON AVE
Second Line	:	SUITE # 6116-18
City	:	CHICAGO
State	:	IL
Zip	:	60640-5255
Country	:	US
Telephone Number	:	773-275-5176
Fax Number	:	773-275-1130

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDWARD ABRAHAM
Credential	:	M.D.
Telephone Number	:	773-275-5177

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	03/19/2010

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Directions to “UPTOWN ORTHOPAEDIC SURGEONS SC ” Practice Location

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