# CHICAGO ORTHOPAEDICS AND SPORTS MEDICINE SC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LINCOLN PARK PHYSICAL THERAPY INSTITUTE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619004082
- **Authorized official:** DAVID A HOFFMAN MD (PRESIDENT)
- **Authorized official phone:** (440) 716-0800

## Contact information

- **Practice address:** 3000 N HALSTED ST, 527, CHICAGO, IL 60657-5188
- **Practice address phone:** (773) 328-5930
- **Practice address fax:** (773) 433-3145
- **Mailing address:** 3000 N HALSTED ST, \#525, CHICAGO, IL 60657-5188
- **Mailing address phone:** (773) 328-5930
- **Mailing address fax:** (773) 433-3145

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/27/2007
- **Last updated:** 03/14/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 130813301 | DOL | IL |
| 01 | — | CC4422 | RR MEDICARE | IL |