Provider Demographics
NPI:1548579576
Name:WEST SUBURBAN SURGICAL, S.C.
Entity Type:Organization
Organization Name:WEST SUBURBAN SURGICAL, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:BORNCAMP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-897-1282
Mailing Address - Street 1:1315 N HIGHLAND AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-1400
Mailing Address - Country:US
Mailing Address - Phone:630-897-1282
Mailing Address - Fax:630-906-9860
Practice Address - Street 1:1315 N HIGHLAND AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1400
Practice Address - Country:US
Practice Address - Phone:630-897-1282
Practice Address - Fax:630-906-9860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Single Specialty