Provider Demographics
NPI:1740309335
Name:SURGERY, S.C.
Entity type:Organization
Organization Name:SURGERY, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:CAHILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-975-5966
Mailing Address - Street 1:1035 W LILL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-2205
Mailing Address - Country:US
Mailing Address - Phone:773-975-5966
Mailing Address - Fax:773-880-0403
Practice Address - Street 1:2800 N SHERIDAN RD
Practice Address - Street 2:SUITE G2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6156
Practice Address - Country:US
Practice Address - Phone:773-880-5666
Practice Address - Fax:773-880-0403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01609339OtherBLUE CROSS
IL440550Medicare ID - Type Unspecified