Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Southside Family Medicine PC

Organization Family Medicine Physician · NPI 1922361450

Southside Family Medicine PC provides Family Medicine Physician services 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 Not confirmed with CMS for 14 years — call before visiting
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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