Provider Demographics
NPI:1336290188
Name:MIDWEST CENTER FOR DAY SURGERY, LLC
Entity Type:Organization
Organization Name:MIDWEST CENTER FOR DAY SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:LADNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-852-9300
Mailing Address - Street 1:3811 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1555
Mailing Address - Country:US
Mailing Address - Phone:630-852-9300
Mailing Address - Fax:630-852-7773
Practice Address - Street 1:3811 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1555
Practice Address - Country:US
Practice Address - Phone:630-852-9300
Practice Address - Fax:630-852-7773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCL4513OtherRAILROAD MEDICARE
IL214934Medicare PIN