Provider Demographics
NPI:1336470087
Name:ARTHRITIS AND AUTOIMMUNE DISEASE CENTER, S.C.
Entity Type:Organization
Organization Name:ARTHRITIS AND AUTOIMMUNE DISEASE CENTER, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RHEUMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAISVYDE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMAJKIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-913-2585
Mailing Address - Street 1:33 W ONTARIO ST
Mailing Address - Street 2:43EN
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-7760
Mailing Address - Country:US
Mailing Address - Phone:773-913-2585
Mailing Address - Fax:
Practice Address - Street 1:5106 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3113
Practice Address - Country:US
Practice Address - Phone:773-913-2585
Practice Address - Fax:773-904-2955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty