MEDICARE: STRAUSS SURGICAL GROUP ASSOC, 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	208800000X	Urology Physician	036036482	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	340007445	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01615141	OTHER	IL	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841217767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRAUSS SURGICAL GROUP ASSOC, S.C.

Provider Business Mailing Address
First Line	:	5501 W 79TH ST
Second Line	:	SUITE 400
City	:	BURBANK
State	:	IL
Zip	:	60459-1784
Country	:	US
Telephone Number	:	773-884-4523
Fax Number	:	773-884-4580

Provider Business Practice Location Address
First Line	:	4640 N MARINE DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5719
Country	:	US
Telephone Number	:	773-564-6200
Fax Number	:	773-564-6201

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HERBERT SOHN
Credential	:	M.D.
Telephone Number	:	773-564-6200

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	10/21/2014

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Directions to “STRAUSS SURGICAL GROUP ASSOC, S.C. ” Practice Location

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