Provider Demographics
NPI:1417146689
Name:CURTIS L SPEED MD HEALTH SERVICES SC
Entity Type:Organization
Organization Name:CURTIS L SPEED MD HEALTH SERVICES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPEED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-217-1450
Mailing Address - Street 1:3601 W 183RD ST
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2409
Mailing Address - Country:US
Mailing Address - Phone:708-957-7623
Mailing Address - Fax:
Practice Address - Street 1:8058 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-5936
Practice Address - Country:US
Practice Address - Phone:773-863-9488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty