Provider Demographics
NPI:1336386705
Name:WEST SUBURBAN NEUROSURGICAL ASSOCIATES, S.C.
Entity Type:Organization
Organization Name:WEST SUBURBAN NEUROSURGICAL ASSOCIATES, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CLAUDEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CALMEYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:6306-550-1229
Mailing Address - Street 1:20 E OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3543
Mailing Address - Country:US
Mailing Address - Phone:630-655-1229
Mailing Address - Fax:630-655-0185
Practice Address - Street 1:800 BIESTERFIELD RD
Practice Address - Street 2:STE 4002
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3361
Practice Address - Country:US
Practice Address - Phone:630-655-1229
Practice Address - Fax:630-655-0185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
603860Medicare PIN