ADVOCATE CONDELL AMBULATORY SURGERY CENTER LLC NPI 1992259337

NPI Information

NPI: 1992259337
Provider Name: ADVOCATE CONDELL AMBULATORY SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 14D2109548

Address:
825 S MILWAUKEE AVE
LIBERTYVILLE, IL
ZIP 60048
Phone: (312) 489-9500
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ADVOCATE CONDELL AMBULATORY SURGERY CENTER, LLC is an ambulatory surgical clinic center in Libertyville, IL. ADVOCATE CONDELL AMBULATORY SURGERY CENTER, LLC NPI is 1992259337. The provider is registered as an organization entity type.

The provider's business location address is:

825 S MILWAUKEE AVE
LIBERTYVILLE, IL
ZIP 60048-218
Phone: (312) 489-9500

The provider's authorized official is Dominica Tallarico .
The authorized official title is Board Chair and has the following contact phone number (847) 990-5201.

The CLIA number assigned to this NPI record is 14D2109548 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/14/2016 and was last updated on 8/14/2016.

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

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: 4/28/2024

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