NOVAMED SURGERY CENTER OF OAK LAWN LLC NPI 1518967082

NPI Information

NOVAMED SURGERY CENTER OF OAK LAWN, LLC is an ambulatory surgical clinic center in Oak Lawn, IL. NOVAMED SURGERY CENTER OF OAK LAWN, LLC NPI is 1518967082. The provider is registered as an organization entity type.
The provider Is Doing Business As Center For Reconstructive Surgery Of Oak Lawn.

The provider's business location address is:

6311 W 95TH ST
OAK LAWN, IL
ZIP 60453-201
Phone: (708) 499-3355
Fax: (708) 425-5654

The provider's authorized official is Jennifer Boyd Baldock .
The authorized official title is Officer And Authorized Official and has the following contact phone number (615) 234-5954.

The CLIA number assigned to this NPI record is 14D0895400 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/27/2005 and was last updated on 11/1/2022.

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:

Other Identifiers

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

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