Organization
CHICAGO MEDICAL AND SURGICAL SPECIALISTS, S. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMSON M. CHAN M. D. (MEDICAL DIRECTOR)
(317) 908-8833
Entity
Organization
Contact information
Practice address
1645 W NORTH AVE, CHICAGO, IL 60622-2543
(224) 404-1097
Mailing address
474 N LAKE SHORE DR, 5206, CHICAGO, IL 60611-3400
(317) 908-8833
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
036134419
IL
208600000X
Surgery Physician
036134419
IL
Other
Enumeration date
11/07/2015
Last updated
11/07/2015
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