Provider Demographics
NPI:1164669909
Name:ROGERS PARK ONE DAY SURGERY CENTER, INC
Entity Type:Organization
Organization Name:ROGERS PARK ONE DAY SURGERY CENTER, INC
Other - Org Name:HERRON MEDICAL CENTER, LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAYAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-337-6072
Mailing Address - Street 1:1150 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-7481
Mailing Address - Country:US
Mailing Address - Phone:312-337-6072
Mailing Address - Fax:312-337-3163
Practice Address - Street 1:1150 N STATE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-7481
Practice Address - Country:US
Practice Address - Phone:312-337-6072
Practice Address - Fax:312-337-3163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty