VASCULAR SURGERY ASSOCIATES PLLC NPI 1538791793

NPI Information

NPI: 1538791793
Provider Name: VASCULAR SURGERY ASSOCIATES, PLLC
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
10258 SOUTHWEST HWY STE A
CHICAGO RIDGE, IL
ZIP 60415
Phone: (708) 346-9533
Get Directions

VASCULAR SURGERY ASSOCIATES, PLLC is a vascular surgery surgery in Chicago Ridge, IL. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. VASCULAR SURGERY ASSOCIATES, PLLC NPI is 1538791793. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10258 SOUTHWEST HWY STE A
CHICAGO RIDGE, IL
ZIP 60415-361
Phone: (708) 346-9533
Fax: (708) 499-4312

The provider's authorized official is Martin Ira Ellenby .
The authorized official title is Manager and has the following contact phone number (708) 346-9533.

The enumeration date for this NPI number is 2/6/2020 and was last updated on 3/27/2020.

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	2086S0129X	Surgery	Vascular Surgery			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	0001538791793	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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