MEDICARE: WILLOW SPRINGS SURGERY CENTER, 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	7002744	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7003273	OTHER	IL	LICENSE

General Provider Information

NPI Number	:	1467429233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLOW SPRINGS SURGERY CENTER, LLC

Provider Business Mailing Address
First Line	:	120 W 22ND ST STE 200
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1563
Country	:	US
Telephone Number	:	630-573-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2055 W ARMY TRAIL RD STE 110N
Second Line	:
City	:	ADDISON
State	:	IL
Zip	:	60101-1478
Country	:	US
Telephone Number	:	773-284-9247
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MANISH TANNA
Credential	:	M.D.
Telephone Number	:	630-573-5000

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	02/04/2026

Similar Medicare Providers

1902355316 — LEGACY MEDICAL CARE INC
Practice Location Address:

2055 W ARMY TRAIL RD
ADDISON, IL
60101-1478

Practice Phone: 847-749-2248
Practice Fax:

1558694521 — ACCESS COMMUNITY HEALTH NETWORK
Practice Location Address:

2055 W ARMY TRAIL RD
ADDISON, IL
60101-1478

Practice Phone: 773-257-6550
Practice Fax:

1912203209 — MATERNAL AND CHILD MEDICAL CARE, S.C
Practice Location Address:

2055 W ARMY TRAIL RD , SUITE 104
ADDISON, IL
60101-1478

Practice Phone: 847-650-1452
Practice Fax: 224-535-7260

1689942500 — ALICE MARIE SARTORE APN
Practice Location Address:

2055 W ARMY TRAIL RD
ADDISON, IL
60101-1478

Practice Phone: 630-705-1739
Practice Fax: 630-705-1049

1114293123 — DR. ANDREW KOWALSKI M.D.
Practice Location Address:

2055 W ARMY TRAIL RD STE 110E
ADDISON, IL
60101-1478

Practice Phone: 773-284-9247
Practice Fax: 773-284-9249

1073853354 — JILL ALEXANDRA SHEPHERD APN
Practice Location Address:

2055 W ARMY TRAIL RD STE 104
ADDISON, IL
60101-1478

Practice Phone: 630-599-5400
Practice Fax: 630-705-1049

Directions to “WILLOW SPRINGS SURGERY CENTER, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.