Provider Demographics
NPI:1043080674
Name:PLUM CREEK SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:PLUM CREEK SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCSHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:708-275-7799
Mailing Address - Street 1:1236 BEMIS HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-6004
Mailing Address - Country:US
Mailing Address - Phone:708-275-7799
Mailing Address - Fax:
Practice Address - Street 1:9200 CALUMET AVE STE N300
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-5811
Practice Address - Country:US
Practice Address - Phone:708-275-7799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical