Basic Information
| Provider Information | |||||||||
| NPI: | 1417146689 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CURTIS L SPEED MD HEALTH SERVICES SC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3601 W 183RD ST | ||||||||
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| City: | HAZEL CREST | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604292409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7089577623 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8058 S WESTERN AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606205936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7738639488 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2007 | ||||||||
| LastUpdateDate: | 10/23/2007 | ||||||||
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| AuthorizedOfficialLastName: | SPEED | ||||||||
| AuthorizedOfficialFirstName: | CURTIS | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3122171450 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | IL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.