Provider Demographics
NPI:1437869062
Name:RIVER NORTH SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:RIVER NORTH SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT OF OPERATI
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-810-0707
Mailing Address - Street 1:2555 PATRIOT BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026
Mailing Address - Country:US
Mailing Address - Phone:847-998-8200
Mailing Address - Fax:847-998-6880
Practice Address - Street 1:361 WEST CHESTNUT STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610
Practice Address - Country:US
Practice Address - Phone:847-998-8200
Practice Address - Fax:847-998-6880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical