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General NPI Number Information
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NPI Number | 1235440835
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Entity Type | Organization
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Legal Business Name | NW SURGICAL CENTER, SC
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 1260 W HIGGINS RD
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169
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Country | US
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Telephone | 847-839-1111
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Fax | 847-839-1123
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Provider Business Mailing Address
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Address Line | 1260 W HIGGINS RD
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169
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Country | US
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Telephone | 847-839-1111
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Fax | 847-839-1123
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Authorized Official
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Title or Position | OFFICE CONSULTANT
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Name | MR. MAHMOUD M TAYEB
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Credential |
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Telephone | 847-387-9365
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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 | 042619629
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License Number State | IL
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