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General NPI Number Information
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NPI Number | 1205234143
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Entity Type | Organization
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Legal Business Name | ORTHOTEC SURGERY CENTER, INC
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 340 W BUTTERFIELD RD SUITE 1B
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City | ELMHURST
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State | IL
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Zip | 60126-5047
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Country | US
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Telephone | 331-209-9903
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Fax | 331-209-9927
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Provider Business Mailing Address
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Address Line | 340 W BUTTERFIELD RD SUITE 1B
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City | ELMHURST
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State | IL
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Zip | 60126
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Country | US
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Telephone | 331-209-9903
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Fax | 331-209-9927
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Authorized Official
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Title or Position | CHAIR / GOVERNING BODY
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Name | DR. THOMAS CARL CARR
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Credential | DPM
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Telephone | 312-860-3112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 7003192
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License Number State | IL
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