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General NPI Number Information
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NPI Number | 1497993596
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Entity Type | Organization
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Legal Business Name | CLINICIANS SURGICAL CARE OF AMERICA LLC
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Dates
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Enumeration Date | 01/27/2009
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 6475 WASHINGTON ST STE 103
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City | GURNEE
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State | IL
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Zip | 60031-4404
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Country | US
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Telephone | 847-855-2396
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Fax | 847-855-2458
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Provider Business Mailing Address
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Address Line | 6475 WASHINGTON ST STE 103
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City | GURNEE
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State | IL
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Zip | 60031-4404
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Country | US
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Telephone | 847-855-2396
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Fax | 847-855-2458
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES A GROSS
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Credential |
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Telephone | 847-855-2396
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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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