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General NPI Number Information
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NPI Number | 1114078060
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Entity Type | Organization
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Legal Business Name | NAPERVILLE SURGICAL CENTRE LLC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/20/2016
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Provider Practice Location Address
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Address Line | 1263 RICKERT DR
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City | NAPERVILLE
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State | IL
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Zip | 60540-0954
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Country | US
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Telephone | 630-305-3300
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Fax | 630-305-3301
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Provider Business Mailing Address
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Address Line | 1263 RICKERT DR
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City | NAPERVILLE
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State | IL
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Zip | 60540-0954
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Country | US
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Telephone | 630-305-3300
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Fax | 630-305-3301
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. RONALD P LADNIAK
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Credential |
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Telephone | 630-869-6395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 7003205
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License Number State | IL
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