Healthcare Provider Details

I. General information

NPI: 1255455366
Provider Name (Legal Business Name): AMERICAN SURGICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5011 N LINCOLN AVE
CHICAGO IL
60625-2611
US

IV. Provider business mailing address

5011 N LINCOLN AVE
CHICAGO IL
60625-2611
US

V. Phone/Fax

Practice location:
  • Phone: 312-993-9999
  • Fax: 773-769-6917
Mailing address:
  • Phone: 312-993-9999
  • Fax: 773-769-6917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VLADIMIR GUSINSKY
Title or Position: MANAGER
Credential:
Phone: 312-993-9999