Provider Demographics
NPI:1285084046
Name:SOUTH CHICAGO ORTHOPEDIC SPECIALISTS, SC
Entity type:Organization
Organization Name:SOUTH CHICAGO ORTHOPEDIC SPECIALISTS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:872-228-0235
Mailing Address - Street 1:1701 W MONTEREY AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-4257
Mailing Address - Country:US
Mailing Address - Phone:872-228-0235
Mailing Address - Fax:773-530-0520
Practice Address - Street 1:1701 W MONTEREY AVE STE 4
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-4257
Practice Address - Country:US
Practice Address - Phone:872-228-0235
Practice Address - Fax:773-530-0520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036118743207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF100321667Medicare PIN