Provider Demographics
NPI:1497993596
Name:CLINICIANS SURGICAL CARE OF AMERICA LLC
Entity Type:Organization
Organization Name:CLINICIANS SURGICAL CARE OF AMERICA LLC
Other - Org Name:CLINICIANS SURGERY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-855-2396
Mailing Address - Street 1:6475 WASHINGTON ST STE 103
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-4404
Mailing Address - Country:US
Mailing Address - Phone:847-855-2396
Mailing Address - Fax:847-855-2458
Practice Address - Street 1:6475 WASHINGTON ST STE 103
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-4404
Practice Address - Country:US
Practice Address - Phone:847-855-2396
Practice Address - Fax:847-855-2458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical