Provider Demographics
NPI:1437722261
Name:GREATER CHICAGO CENTER FOR ADVANCED SURGERY LLC
Entity Type:Organization
Organization Name:GREATER CHICAGO CENTER FOR ADVANCED SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:K
Authorized Official - Last Name:KRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-725-5850
Mailing Address - Street 1:999 E TOUHY AVE STE 450
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-2748
Mailing Address - Country:US
Mailing Address - Phone:224-725-5850
Mailing Address - Fax:
Practice Address - Street 1:999 E TOUHY AVE STE 350
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-2736
Practice Address - Country:US
Practice Address - Phone:224-725-5850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical