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General NPI Number Information
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NPI Number | 1548538192
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Entity Type | Organization
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Legal Business Name | SURGICAL ASSISTING SOLUTIONS, LLC
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Dates
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Enumeration Date | 12/11/2011
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Last Update Date | 04/22/2014
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Provider Practice Location Address
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Address Line | 16525 W 159TH ST #140
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City | LOCKPORT
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State | IL
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Zip | 60441-7900
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Country | US
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Telephone | 708-602-2183
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Fax | 815-600-8637
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Provider Business Mailing Address
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Address Line | 16525 W 159TH ST #140
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City | LOCKPORT
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State | IL
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Zip | 60441-7900
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Country | US
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Telephone | 708-602-2183
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Fax | 815-600-8637
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Authorized Official
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Title or Position | OWNER
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Name | MR. NOEL C TEODORO
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Credential | RSA
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Telephone | 708-602-2183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 238.000243
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License Number State | IL
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