Provider Demographics
NPI:1578654075
Name:CHICAGO VOICE & SWALLOWING CENTERS, LTD
Entity Type:Organization
Organization Name:CHICAGO VOICE & SWALLOWING CENTERS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHAROUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-729-9122
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60065-0156
Mailing Address - Country:US
Mailing Address - Phone:224-436-5420
Mailing Address - Fax:847-291-6587
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:SUITE 321
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:224-436-5420
Practice Address - Fax:847-291-6587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036084409261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01636671OtherBCBS
IL214592OtherMEDICARE PTAN
ILG49266Medicare UPIN
IL01636671OtherBCBS