MEDICARE: SURGICAL CENTER FOR HUMAN REPRODUCTION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1104633866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGICAL CENTER FOR HUMAN REPRODUCTION, LLC

Provider Business Mailing Address
First Line	:	680 N LAKE SHORE DR STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4447
Country	:	US
Telephone Number	:	312-288-6420
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 N LAKE SHORE DR STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4447
Country	:	US
Telephone Number	:	312-288-6420
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	BETH ZONERAICH
Credential	:
Telephone Number	:	602-834-7227

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	03/05/2026

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