Healthcare Provider Details

I. General information

NPI: 1558344846
Provider Name (Legal Business Name): ALGONQUIN ROAD SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 W ALGONQUIN RD
LAKE IN THE HILLS IL
60156-3503
US

IV. Provider business mailing address

2550 W ALGONQUIN RD
LAKE IN THE HILLS IL
60156-3503
US

V. Phone/Fax

Practice location:
  • Phone: 847-458-1246
  • Fax: 847-458-1509
Mailing address:
  • Phone: 847-458-1246
  • Fax: 847-458-1509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JUDITH KAZY-GAREY
Title or Position: EXECUTIVE DIRECTOR
Credential: MA
Phone: 847-960-1044