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FULLERTON SURGERY CENTER LTD NPI 1285675678


NPI Information

NPI: 1285675678
Provider Name: FULLERTON SURGERY CENTER LTD

Other Name: FULLERTON SURGERY CENTER INC

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
4849 W FULLERTON AVE
CHICAGO, IL
ZIP 60639
Phone: (773) 237-2900
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FULLERTON SURGERY CENTER LTD is an ambulatory surgical clinic center in Chicago, IL. FULLERTON SURGERY CENTER LTD NPI is 1285675678. The provider is registered as an organization entity type.
The provider Other Name Is Fullerton Surgery Center Inc.

The provider's business location address is:

4849 W FULLERTON AVE
CHICAGO, IL
ZIP 60639-503
Phone: (773) 237-2900
Fax: (773) 622-0769

The provider's authorized official is Naser Rustom .
The authorized official title is Owner/medical Director and has the following contact phone number (773) 237-2900.

The enumeration date for this NPI number is 6/9/2006 and was last updated on 2/6/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA1903XClinic/CenterAmbulatory Surgical042618689ILLINOISYes

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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