Provider Demographics
NPI:1558533711
Name:COMPREHENSIVE SURGICAL SERVICES LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE SURGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VISHNU
Authorized Official - Middle Name:N
Authorized Official - Last Name:MATHUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-937-2187
Mailing Address - Street 1:2315 E 93RD ST
Mailing Address - Street 2:SUITE 340
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-3936
Mailing Address - Country:US
Mailing Address - Phone:219-937-2187
Mailing Address - Fax:219-365-2677
Practice Address - Street 1:5500 S HOHMAN AVE
Practice Address - Street 2:SUITE IE
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320-1965
Practice Address - Country:US
Practice Address - Phone:219-937-2187
Practice Address - Fax:219-365-2677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01049977A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN151940Medicare PIN