Organization
HEALTH CARE ONE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE SIANIS MD (PRESIDENT)
(773) 478-5600
Entity
Organization
Contact information
Practice address
4921 N WESTERN AVE, CHICAGO, IL 60625-1921
(773) 478-5600
(773) 478-5602
Mailing address
4921 N WESTERN AVE, CHICAGO, IL 60625-1921
(773) 478-5600
(773) 478-5602
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635073
BCBS
IL
01
—
14D0907680
CLIA
IL
01
—
DF7575
RAILROAD MEDICARE
IL
Enumeration date
07/05/2006
Last updated
12/04/2023
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