RIVER FOREST SURGERY CENTER LLC NPI 1083615470

NPI Information

NPI: 1083615470
Provider Name: RIVER FOREST SURGERY CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 14D2077484

Address:
7427 LAKE ST
RIVER FOREST, IL
ZIP 60305
Phone: (708) 488-1200
Get Directions

RIVER FOREST SURGERY CENTER LLC is an ambulatory surgical clinic center in River Forest, IL. RIVER FOREST SURGERY CENTER LLC NPI is 1083615470. The provider is registered as an organization entity type.

The provider's business location address is:

7427 LAKE ST
RIVER FOREST, IL
ZIP 60305-817
Phone: (708) 488-1200
Fax: (708) 771-7321

The provider's authorized official is Lisa Gill .
The authorized official title is Administrator and has the following contact phone number (708) 771-3334.

The CLIA number assigned to this NPI record is 14D2077484 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/9/2005 and was last updated on 3/30/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	7002561	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	490005430	OTHER		RR MEDICARE
2	=========001	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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