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Organization

TREISTER ORTHOPAEDIC SERVICES LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL ROY TREISTER M.D. (HEAD OFFICIAL)
(312) 633-5866
Entity
Organization

Contact information

Practice address
1431 N WESTERN AVE, SUITE 510, CHICAGO, IL 60622-1797
(312) 633-5866
(312) 491-5096
Mailing address
1431 N WESTERN AVE, SUITE 510, CHICAGO, IL 60622-1797
(312) 633-5866

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36042189
IL
174400000X
Specialist
36057244
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1615856
BCBS
IL
Enumeration date
01/30/2006
Last updated
01/13/2009
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