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HYDE PARK SURGICAL CENTER LLC NPI 1205214103


NPI Information

NPI: 1205214103
Provider Name: HYDE PARK SURGICAL CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 14D2095792

Address:
1644 E 53RD ST
CHICAGO, IL
ZIP 60615
Phone: (773) 752-6340
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HYDE PARK SURGICAL CENTER LLC is an ambulatory surgical clinic center in Chicago, IL. HYDE PARK SURGICAL CENTER LLC NPI is 1205214103. The provider is registered as an organization entity type.

The provider's business location address is:

1644 E 53RD ST
CHICAGO, IL
ZIP 60615-210
Phone: (773) 752-6340
Fax: (773) 752-6368

The provider's authorized official is Melissa Rice .
The authorized official title is Adminsitrator and has the following contact phone number (773) 752-6340.

The CLIA number assigned to this NPI record is 14D2095792 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/11/2015 and was last updated on 8/11/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA1903XClinic/CenterAmbulatory Surgical036130154ILLINOISYes

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: 11/14/2023

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