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Organization
CHICAGO ORTHOPAEDIC & SPORTS MEDICINE SC
Active
Organization
CHICAGO ORTHOPAEDIC & SPORTS MEDICINE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GUELICH MD (PRESIDENT)
(773) 433-3130
Entity
Organization
Contact information
Practice address
3000 N HALSTED ST, SUITE 525, CHICAGO, IL 60657
(773) 433-3130
(773) 433-3125
Mailing address
3000 N HALSTED ST, #525, CHICAGO, IL 60657-5188
(773) 433-3130
(773) 433-3125
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
213ES0131X
Foot Surgery Podiatrist
—
NULL
213ES0131X
Foot Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130813300
DEPT OF LABOR
IL
01
—
CC4422
RAILROAD MEDICARE
IL
Enumeration date
03/15/2006
Last updated
10/07/2015
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