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General NPI Number Information
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NPI Number | 1558344846
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Entity Type | Organization
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Legal Business Name | ALGONQUIN ROAD SURGERY CENTER, LLC
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 2550 W ALGONQUIN RD
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-3503
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Country | US
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Telephone | 847-458-1246
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Fax | 847-458-1509
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Provider Business Mailing Address
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Address Line | 2550 W ALGONQUIN RD
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-3503
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Country | US
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Telephone | 847-458-1246
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Fax | 847-458-1509
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JUDITH KAZY-GAREY
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Credential | MA
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Telephone | 847-960-1044
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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 | IL
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