Provider Demographics
NPI:1629256961
Name:BELMONT/HARLEM SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:BELMONT/HARLEM SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCHALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-889-2000
Mailing Address - Street 1:3101 N HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4532
Mailing Address - Country:US
Mailing Address - Phone:773-889-2000
Mailing Address - Fax:
Practice Address - Street 1:3101 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4532
Practice Address - Country:US
Practice Address - Phone:773-889-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical