Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southside Family Medicine PC

Organization Family Medicine Physician · NPI 1922361450

Southside Family Medicine PC is a Family Medicine Physician in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2012.

Licensed in
IL
In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1525 E 55th St Ste 307
Chicago, IL 60615-5512
Phone: (773) 667-5577
Fax: (773) 667-9977
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 336.073573 (IL)

Record details

NPI number1922361450
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carlos Crudup — President · (773) 667-5577
NPI enumeratedJune 19, 2012
Last updated in NPPESJune 19, 2012
Mailing address1446 E 63rd St, Chicago, IL 60637-2948

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