Provider Demographics
NPI:1467429233
Name:WILLOW SPRINGS SURGERY CENTER, LTD
Entity type:Organization
Organization Name:WILLOW SPRINGS SURGERY CENTER, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:TANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-573-5000
Mailing Address - Street 1:120 W 22ND ST
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1557
Mailing Address - Country:US
Mailing Address - Phone:630-573-5000
Mailing Address - Fax:630-368-0280
Practice Address - Street 1:2055 W ARMY TRAIL RD STE 110
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-1478
Practice Address - Country:US
Practice Address - Phone:773-284-9247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL7002744261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209786Medicare ID - Type Unspecified