Provider Demographics
NPI:1235683798
Name:ASSOCIATED SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:ASSOCIATED SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVITIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-215-0530
Mailing Address - Street 1:129 W RAND RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-3142
Mailing Address - Country:US
Mailing Address - Phone:847-215-0530
Mailing Address - Fax:847-215-0951
Practice Address - Street 1:129 W RAND RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3142
Practice Address - Country:US
Practice Address - Phone:847-215-0530
Practice Address - Fax:847-215-0951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-12
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL7003204261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical