Provider Demographics
NPI:1376615518
Name:CHICAGO SURGICARE, PC
Entity Type:Organization
Organization Name:CHICAGO SURGICARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:773-324-3338
Mailing Address - Street 1:1424 E 53RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4500
Mailing Address - Country:US
Mailing Address - Phone:773-324-3338
Mailing Address - Fax:773-324-1866
Practice Address - Street 1:1424 E 53RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4500
Practice Address - Country:US
Practice Address - Phone:773-324-3338
Practice Address - Fax:773-324-1866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric