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General NPI Number Information
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NPI Number | 1033248927
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Entity Type | Organization
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Legal Business Name | PARTNERS IN SURGICAL CARE LLC
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17W662 BUTTERFIELD RD SUITE 306B
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-4098
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Country | US
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Telephone | 630-916-6504
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Fax | 630-916-6743
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Provider Business Mailing Address
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Address Line | 409 W HURON ST SUITE 301
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City | CHICAGO
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State | IL
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Zip | 60610-3431
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Country | US
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Telephone | 312-676-0828
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Fax | 312-787-6458
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Authorized Official
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Title or Position | COO
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Name | DR. KENNY BOZORGI
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Credential | M.D.
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Telephone | 312-787-7861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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