Provider Demographics
NPI:1992380943
Name:ACUTE CARE SURGERY MIDWEST, S.C.
Entity Type:Organization
Organization Name:ACUTE CARE SURGERY MIDWEST, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF LEGAL AFFAIRS
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-441-0400
Mailing Address - Street 1:PO BOX 208980
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-0001
Mailing Address - Country:US
Mailing Address - Phone:916-441-0400
Mailing Address - Fax:
Practice Address - Street 1:7309 N KNOXVILLE AVE STE 1
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-2086
Practice Address - Country:US
Practice Address - Phone:916-441-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty