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General NPI Number Information
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NPI Number | 1922275494
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Entity Type | Organization
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Legal Business Name | SUBURBAN SURGICAL CARE CENTER LTD
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 3100 W HIGGINS RD STE 150
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-7256
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Country | US
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Telephone | 847-885-9525
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Fax | 847-885-9527
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Provider Business Mailing Address
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Address Line | 3100 W HIGGINS RD STE 150
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-7256
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Country | US
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Telephone | 847-885-9525
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Fax | 847-885-9527
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT NEWCOMB
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Credential | DPM
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Telephone | 847-885-9525
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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 | 016005040
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License Number State | IL
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