Healthcare Provider Details

I. General information

NPI: 1225076706
Provider Name (Legal Business Name): NORTHWESTERN SURGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 10/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 N SAINT CLAIR ST STE 1525
CHICAGO IL
60611-2927
US

IV. Provider business mailing address

PO BOX 421
WINNETKA IL
60093-0421
US

V. Phone/Fax

Practice location:
  • Phone: 312-943-5427
  • Fax: 312-266-0478
Mailing address:
  • Phone: 847-770-6043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN J STRYKER
Title or Position: PARTNER
Credential: M.D.
Phone: 312-943-5427