Hyde Park Medical Specialty Group, Llc
LBN: Hyde Park Medical Specialty Group, Llc
Hyde Park Medical Specialty Group, Llc is an health care organization with primary practice located at 1644 E 53Rd St , Chicago IL 60615-4210. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is the primary health care specialty.
Hyde Park Medical Specialty Group, Llc can be contacted via phone (773) 752-2111, or through Massuda, Fortunee via phone (773) 752-2111.
Contact Information
Primary practice address
1644 E 53Rd St
Chicago IL 60615-4210
Phone: (773) 752-2111
Fax: (773) 752-6703
Website:
Authorized official contact:
Name: Massuda, Fortunee Doctor of Podiatric Medicine (DPM)
Phone: (773) 752-2111
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | Illinois |
Profile Details
| NPI number | 1588656037 |
|---|---|
| LBN Legal business name | Hyde Park Medical Specialty Group, Llc |
| DBA Doing business as | |
| Authorized official | Massuda, Fortunee Doctor of Podiatric Medicine (DPM) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 19th, 2005 |
| Last updated | Jul 19th, 2012 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588656037 | NPPES |
| Illinois | Other | 01633434 | BCBS |
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