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NPI Code Detail

MEDICARE: ADVANCED SURGICAL ASSOCIATES, S.C.

MEDICARE: ADVANCED SURGICAL ASSOCIATES, S.C.
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
1208600000XSurgery Physician

General Provider Information

NPI Number : 1346205390
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED SURGICAL ASSOCIATES, S.C.
Provider Business Mailing Address
First Line : 880 WEST CENTRAL ROAD
Second Line : SUITE 3800
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-2369
Country : US
Telephone Number : 847-483-9800
Fax Number : 847-483-9808
Provider Business Practice Location Address
First Line : 880 WEST CENTRAL ROAD
Second Line : SUITE 3800
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-2369
Country : US
Telephone Number : 847-483-9800
Fax Number : 847-483-9808
Authorized Official
Title or Position : PRESIDENT
Name : ALAN BRUCE LOREN
Credential : M.D.
Telephone Number : 847-483-9800
Provider Enumeration Date : 04/20/2006
Last Update Date : 03/01/2011

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