HYDE PARK SURGERY CENTER LLC NPI 1609868041

NPI Information

NPI: 1609868041
Provider Name: HYDE PARK SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
1644 E 53RD ST
CHICAGO, IL
ZIP 60615
Phone: (773) 752-2111
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HYDE PARK SURGERY CENTER, LLC is an ambulatory surgical clinic center in Chicago, IL. HYDE PARK SURGERY CENTER, LLC NPI is 1609868041. 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) 752-2111
Fax: (773) 752-6703

The provider's authorized official is Fortunee Massuda .
The authorized official title is Medical Director & Ceo and has the following contact phone number (773) 752-2111.

The enumeration date for this NPI number is 8/22/2005 and was last updated on 11/23/2009.

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	261QA1903X	Clinic/Center	Ambulatory Surgical			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	212062	MEDICARE PIN
2	50460	OTHER	ILLINOIS	BCBS
3	5506750001	MEDICARE NSC	ILLINOIS
4	1609868041	MEDICARE PIN	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: 11/14/2023

NPI Synchronization or Removal

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