Provider Demographics
NPI:1679691612
Name:MIDWESTERN SURGICAL SERVICES
Entity Type:Organization
Organization Name:MIDWESTERN SURGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:PROF
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEKATSOS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:630-261-1280
Mailing Address - Street 1:1263 S HIGHLAND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1263 S HIGHLAND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4516
Practice Address - Country:US
Practice Address - Phone:630-261-1280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical