Provider Demographics
NPI:1619469244
Name:RUSH OAK BROOK SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:RUSH OAK BROOK SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:DON
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-824-6250
Mailing Address - Street 1:2011 YORK RD
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60521
Mailing Address - Country:US
Mailing Address - Phone:630-472-2445
Mailing Address - Fax:630-472-2446
Practice Address - Street 1:2011 YORK ROAD
Practice Address - Street 2:SUITE 3000
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60521
Practice Address - Country:US
Practice Address - Phone:304-722-4456
Practice Address - Fax:630-472-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-30
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Multi-Specialty