Provider Demographics
NPI:1154750024
Name:CHICAGO SCIENCES MEDICAL CORPORATION
Entity type:Organization
Organization Name:CHICAGO SCIENCES MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SATHISH
Authorized Official - Middle Name:N
Authorized Official - Last Name:BABU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-553-9058
Mailing Address - Street 1:8346 LEMONT ROAD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561
Mailing Address - Country:US
Mailing Address - Phone:630-581-9414
Mailing Address - Fax:
Practice Address - Street 1:8348 LEMONT ROAD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561
Practice Address - Country:US
Practice Address - Phone:630-581-9414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036122098207R00000X, 207RA0401X, 207RC0000X, 207RG0300X, 208600000X
IN036122098208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty