Healthcare Provider Details

I. General information

NPI: 1336022896
Provider Name (Legal Business Name): SURGERY CENTER OF ILLINOIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 W 95TH ST
OAK LAWN IL
60453-2105
US

IV. Provider business mailing address

6701 W 95TH ST
OAK LAWN IL
60453-2105
US

V. Phone/Fax

Practice location:
  • Phone: 708-599-5000
  • Fax:
Mailing address:
  • Phone: 708-599-5000
  • Fax:

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: MS. SARA ARRIVO
Title or Position: BSN RN
Credential:
Phone: 708-599-5000