Provider Demographics
NPI:1801447883
Name:XAVIER SURGICAL CARE,LLC
Entity type:Organization
Organization Name:XAVIER SURGICAL CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KARL
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C,MSN
Authorized Official - Phone:815-735-2277
Mailing Address - Street 1:21200 S LAGRANGE RD STE 178
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-2003
Mailing Address - Country:US
Mailing Address - Phone:815-735-2277
Mailing Address - Fax:
Practice Address - Street 1:3700 W 203RD ST STE 202
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1182
Practice Address - Country:US
Practice Address - Phone:815-735-2277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:21200 SOUTH LAGRANGE SUITE 178 FRANKFORT ILLINOIS 60423
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-21
Last Update Date:2019-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty