Provider Demographics
NPI:1760698997
Name:POPULAR CREEK SURGERY CENTER
Entity Type:Organization
Organization Name:POPULAR CREEK SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:B
Authorized Official - Last Name:MERCHANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-839-8800
Mailing Address - Street 1:PO BOX 957706
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-7706
Mailing Address - Country:US
Mailing Address - Phone:847-839-8800
Mailing Address - Fax:847-839-8808
Practice Address - Street 1:1585 BARRINGTON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60194-1090
Practice Address - Country:US
Practice Address - Phone:847-839-4000
Practice Address - Fax:847-839-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090326174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty