| Chicago Musculoskeletal Institute, S.c. | |
|
5025 N Paulina St Chicago IL 60640-2772 | |
| (773) 675-9900 | |
| (800) 281-6952 |
| Full Name | Chicago Musculoskeletal Institute, S.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 5025 N Paulina St, Chicago, Illinois |
| Authorized Official Name and Position | Daniel T Ivankovich (OWNER) |
| Authorized Official Contact | 7736759900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Musculoskeletal Institute, S.c. Po Box 1150 Glenview IL 60025-8150 Ph: (773) 675-9900 | Chicago Musculoskeletal Institute, S.c. 5025 N Paulina St Chicago IL 60640-2772 Ph: (773) 675-9900 |
| NPI Number | 1528153335 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 05/08/2013 |
| Medicare PECOS PAC ID | 3274597208 |
|---|---|
| Medicare Enrollment ID | O20041118000480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528153335 | NPI | - | NPPES |
| 036105713 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 036105713 (Illinois) | Primary |
| Provider Name | Daniel T Ivankovich |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003864539 PECOS PAC ID: 6103805452 Enrollment ID: I20040719001328 |
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