Park Ridge Orthopedic Surgeons,S.C.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PARK RIDGE ORTHOPEDIC SURGEONS,S.C.

Practice address

7447 W Talcott Ave
Suite 515
Chicago, IL 60631-3745

Phone

(773) 774-3501

Fax

(773) 774-3511

NPI assigned

Feb 28, 2007

Last updated

Mar 12, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jan M Daczkewycz, B.S.

Title

Manager

Phone

(774) 774-3501

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1942338256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W. TALCOTT RD.",
            "address_2": "SUITE 515",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-774-3501",
            "fax_number": "773-774-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "SUITE 515",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-774-3501",
            "fax_number": "773-774-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK RIDGE ORTHOPEDIC SURGEONS,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "DACZKEWYCZ",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "774-774-3501",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Chicago, IL
• Providers in Chicago, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.