Organization
CHICAGO ORTHOPAEDIC & SPORTS MEDICINE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID R GUELICH MD (PRESIDENT)
(773) 880-0400
Entity
Organization
Contact information
Practice address
2845 N SHERIDAN RD, SUITE 6400, CHICAGO, IL 60657-5194
(773) 665-8400
(773) 665-8716
Mailing address
3000 N HALSTED ST, 525, CHICAGO, IL 60657-5188
(773) 880-0400
(773) 880-0066
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130813301
DEPT OF LABOR
—
01
—
CC4422
RR MEDICARE
IL
Enumeration date
08/30/2006
Last updated
10/13/2015
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