Organization
CHICAGO MUSCULOSKELETAL INSTITUTE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL T IVANKOVICH M.D. (OWNER)
(217) 341-3935
Entity
Organization
Contact information
Practice address
5645 W ADDISON ST, CHICAGO, IL 60634-4403
(217) 341-3935
(800) 281-6952
Mailing address
PO BOX 411303, SAINT LOUIS, MO 63141-1303
(773) 675-9900
(800) 281-6952
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
036105713
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105713
—
IL
Enumeration date
10/04/2006
Last updated
01/20/2026
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