Provider Demographics
NPI:1417028879
Name:SURGICAL SPECIALTY CENTER, LTD.
Entity Type:Organization
Organization Name:SURGICAL SPECIALTY CENTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BETMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:773-745-1919
Mailing Address - Street 1:6043 W BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-5116
Mailing Address - Country:US
Mailing Address - Phone:773-745-5400
Mailing Address - Fax:773-745-1998
Practice Address - Street 1:6043 W BELMONT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-5116
Practice Address - Country:US
Practice Address - Phone:773-745-5400
Practice Address - Fax:773-745-1998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center