Organization
NORTH SHORE SPORTS MEDICINE AND ORTHOPAEDIC CENTER, LTD.
Active
Other names
Illinois Sports Medicine and Orthopaedic Centers
Organization subpart
No
Provider details
NPI number
Authorized official
CHADWICK PRODROMOS M.D. (PRESIDENT)
(847) 699-6810
Entity
Organization
Contact information
Practice address
1714 MILWAUKEE AVE, GLENVIEW, IL 60025-1441
(847) 699-6810
(847) 699-2854
Mailing address
1714 MILWAUKEE AVE, GLENVIEW, IL 60025-1441
(847) 688-6810
(847) 699-2854
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131650500
OWCP FOR DEPT OF LABOR
IL
01
—
1618365
BC/BS
IL
01
—
200030424
RAILROAD MEDICARE
IL
Enumeration date
06/20/2006
Last updated
06/24/2010
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