MEDICARE: METRO SURGICAL SERVICES INC

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
1	261QA1903X	Ambulatory Surgical Clinic/Center	162960	IL

General Provider Information

NPI Number	:	1720292006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METRO SURGICAL SERVICES INC

Provider Business Mailing Address
First Line	:	4612 NORTH HARLEM
Second Line	:	SUITE 3
City	:	HARWOOD HEIGHTS
State	:	IL
Zip	:	60706
Country	:	US
Telephone Number	:	708-867-3003
Fax Number	:	708-867-1964

Provider Business Practice Location Address
First Line	:	4612 NORTH HARLEM
Second Line	:	SUITE 3
City	:	HARWOOD HEIGHTS
State	:	IL
Zip	:	60706
Country	:	US
Telephone Number	:	708-867-3003
Fax Number	:	708-867-1964

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PHILIP FORNI
Credential	:	DPM
Telephone Number	:	708-867-3003

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	08/22/2020

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Directions to “METRO SURGICAL SERVICES INC ” Practice Location

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