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NPI Code Detail

MEDICARE: SUBURBAN SURGICAL SERVICES

MEDICARE: SUBURBAN SURGICAL SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM2500XMedical Specialty Clinic/CenterD6144-486-6IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1D6144-486-6OTHERILCORP #

General Provider Information

NPI Number : 1447335948
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUBURBAN SURGICAL SERVICES
Provider Business Mailing Address
First Line : 900 W. ROUTE 22
Second Line : SUITE 120A
City : LAKE ZURICH
State : IL
Zip : 60047-3416
Country : US
Telephone Number : 847-550-0040
Fax Number : 847-550-0022
Provider Business Practice Location Address
First Line : 900 W. ROUTE 22
Second Line : SUITE 120A
City : LAKE ZURICH
State : IL
Zip : 60047-3416
Country : US
Telephone Number : 847-550-0040
Fax Number : 847-550-0022
Authorized Official
Title or Position : OWNER & CEO
Name : MR. SALVADOR YUNEZ
Credential : M.D.
Telephone Number : 847-550-0040
Provider Enumeration Date : 10/25/2006
Last Update Date : 08/22/2020

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Directions to “SUBURBAN SURGICAL SERVICES ” Practice Location

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