NPI: 1861684458
Provider Name: HISPANIC AMERICAN ENDOSCOPY CENTER, LLC
Doing Business As: CHICAGO SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization
Specialization: Ambulatory Surgical
CLIA Number: 14D1071140
Address:
3536 W FULLERTON AVE
CHICAGO, IL
ZIP 60647
Phone: (773) 772-1212
Get Directions
HISPANIC AMERICAN ENDOSCOPY CENTER, LLC is an ambulatory surgical clinic center in Chicago, IL. HISPANIC AMERICAN ENDOSCOPY CENTER, LLC NPI is 1861684458. The provider is registered as an organization entity type.
The provider Is Doing Business As Chicago Surgery Center, Llc.
The provider's business location address is:
3536 W FULLERTON AVE
CHICAGO, IL
ZIP 60647-443
Phone: (773) 772-1212
Fax: (773) 697-8305
The provider's authorized official is Ryan Rosenthal .
The authorized official title is Owner and has the following contact phone number (312) 761-0100.
The CLIA number assigned to this NPI record is 14D1071140 - ambulatory surgery center with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 8/16/2007 and was last updated on 4/17/2019.