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General NPI Number Information
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NPI Number | 1174501266
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Entity Type | Organization
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Legal Business Name | ASSOCIATED GENERAL SURGEONS, S.C.
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 25 N WINFIELD RD STE 410
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City | WINFIELD
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State | IL
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Zip | 60190-1237
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Country | US
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Telephone | 630-665-2101
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Fax | 630-665-3820
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Provider Business Mailing Address
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Address Line | 25 N WINFIELD RD STE 410
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City | WINFIELD
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State | IL
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Zip | 60190-1237
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Country | US
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Telephone | 630-665-2101
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Fax | 630-665-3820
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | KATHY ANN CARNEY
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Credential |
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Telephone | 630-665-2101
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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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