Provider Demographics
NPI:1558600957
Name:CHICAGO INSTITUTE OF ADVANCED SURGERY
Entity Type:Organization
Organization Name:CHICAGO INSTITUTE OF ADVANCED SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMI
Authorized Official - Middle Name:E
Authorized Official - Last Name:LUTFI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-327-6800
Mailing Address - Street 1:3000 N HALSTED ST STE 703
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5196
Mailing Address - Country:US
Mailing Address - Phone:773-327-6800
Mailing Address - Fax:773-327-6877
Practice Address - Street 1:3000 N HALSTED ST STE 703
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657
Practice Address - Country:US
Practice Address - Phone:773-327-6800
Practice Address - Fax:773-327-6877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36124476Medicaid
F400193534OtherMC