Provider Demographics
NPI:1346205390
Name:ADVANCED SURGICAL ASSOCIATES, S.C.
Entity Type:Organization
Organization Name:ADVANCED SURGICAL ASSOCIATES, S.C.
Other - Org Name:KINNEY, LOREN AND CONWAY, S.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:LOREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-483-9800
Mailing Address - Street 1:880 WEST CENTRAL ROAD
Mailing Address - Street 2:SUITE 3800
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2369
Mailing Address - Country:US
Mailing Address - Phone:847-483-9800
Mailing Address - Fax:847-483-9808
Practice Address - Street 1:880 WEST CENTRAL ROAD
Practice Address - Street 2:SUITE 3800
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2369
Practice Address - Country:US
Practice Address - Phone:847-483-9800
Practice Address - Fax:847-483-9808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty