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General NPI Number Information
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NPI Number | 1447585724
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Entity Type | Organization
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Legal Business Name | BARSURG PROCEDURE CENTER LTD
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 10/05/2009
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Provider Practice Location Address
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Address Line | 22285 PEPPER RD
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City | LAKE BARRINGTON
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State | IL
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Zip | 60010-5914
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Country | US
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Telephone | 847-852-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 8 OAK LAKE DR
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City | BARRINGTON
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State | IL
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Zip | 60010-5914
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. TINA E FRY
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Credential | CPC
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Telephone | 224-535-7009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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