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Specialty details in registry · Chicago, IL

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At a glance

1524 S Sangamon St Unit 512, Chicago, IL 60608-2268

NPPES record updated Apr 18, 2008. Public records can lag behind changes at a practice.

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  • Are you accepting new patients?
  • Do you accept my specific insurance plan?
  • Do you provide the service I need at this address?
  • Do I need a referral, and what is the earliest appointment?

Insurance participation and appointment availability are not established by these public records.

Practice location

1524 S Sangamon St Unit 512
Chicago, IL 60608-2268
Professional details: NPI, taxonomy & registry record
NPI1760656987
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
3336C0002X
Enumeration date
Apr 18, 2008
Record updated
Apr 18, 2008
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

3336C0002X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1524 S Sangamon St Unit 512
Chicago, IL 60608-2268
Phone
(312) 850-2415
Fax
(312) 850-2415
Mailing address
1524 S SANGAMON ST UNIT 512

CHICAGO, IL 606082268
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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