Provider Demographics
NPI:1821544750
Name:AFFORDABLE OFFICE BASED SURGERY
Entity Type:Organization
Organization Name:AFFORDABLE OFFICE BASED SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-944-0365
Mailing Address - Street 1:5600 N SHERIDAN RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660
Mailing Address - Country:US
Mailing Address - Phone:773-944-0365
Mailing Address - Fax:
Practice Address - Street 1:5600 N SHERIDAN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-4877
Practice Address - Country:US
Practice Address - Phone:773-944-0365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036120188261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain