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General NPI Number Information
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NPI Number | 1427124866
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Entity Type | Organization
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Legal Business Name | SEVEN BRIDGES SURGICAL FACILITY
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3540 SEVEN BRIDGES DR SUITE 290
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City | WOODRIDGE
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State | IL
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Zip | 60517-1221
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Country | US
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Telephone | 630-852-8522
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Fax | 630-541-2214
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Provider Business Mailing Address
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Address Line | 3540 SEVEN BRIDGES DR SUITE 290
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City | WOODRIDGE
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State | IL
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Zip | 60517-1221
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Country | US
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Telephone | 630-852-8522
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Fax | 630-541-2214
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. LEONARD E. VEKKOS
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Credential | DPM
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Telephone | 630-852-8522
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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 |
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License Number State |
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