# GAJDA SPORTS MEDICAL CENTER LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114063989
- **Authorized official:** KAREN DALE GAJDA DO (OWNER DOCTOR)
- **Authorized official phone:** (708) 352-2392

## Contact information

- **Practice address:** 400 LAKE COOK ROAD SUITE 200C, DEERFIELD, IL 60015
- **Practice address phone:** (708) 352-2392
- **Practice address fax:** (708) 352-2738
- **Mailing address:** 521 MALDEN AVE, LA GRANGE PARK, IL 60526-5514
- **Mailing address phone:** (708) 352-2392
- **Mailing address fax:** (708) 352-2738

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 036066049 | IL | Yes |

## Other

- **Enumeration date:** 01/29/2007
- **Last updated:** 01/22/2013