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NPI Code Detail

MEDICARE: APM SURGICAL GROUP, LTD

MEDICARE: APM SURGICAL GROUP, LTD
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
1261QA1903XAmbulatory Surgical Clinic/Center042620100IL

General Provider Information

NPI Number : 1184967614
Entity Type Code : Organization
Provider Name (Legal Business Name) : APM SURGICAL GROUP, LTD
Provider Business Mailing Address
First Line : 2937 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-2753
Country : US
Telephone Number : 773-309-0141
Fax Number :
Provider Business Practice Location Address
First Line : 2937 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-2753
Country : US
Telephone Number : 773-309-0141
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. RYAN ROSENTHAL
Credential : D.C.
Telephone Number : 773-309-0141
Provider Enumeration Date : 04/03/2013
Last Update Date : 04/03/2013

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