Provider Demographics
NPI:1215170246
Name:ILLINOIS SURGICAL SPECIALISTS, LTD
Entity type:Organization
Organization Name:ILLINOIS SURGICAL SPECIALISTS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHIOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-495-0240
Mailing Address - Street 1:7725 N KNOXVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-2079
Mailing Address - Country:US
Mailing Address - Phone:309-495-0240
Mailing Address - Fax:309-689-9035
Practice Address - Street 1:7725 N KNOXVILLE AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-2079
Practice Address - Country:US
Practice Address - Phone:309-495-0240
Practice Address - Fax:309-689-9035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
No2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric UrologyGroup - Single Specialty