MEDICARE: PALOS SURGICENTER, LLC

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		IL

General Provider Information

NPI Number	:	1942335971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALOS SURGICENTER, LLC

Provider Business Mailing Address
First Line	:	7340 W COLLEGE DR
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1159
Country	:	US
Telephone Number	:	708-361-3233
Fax Number	:	708-361-4876

Provider Business Practice Location Address
First Line	:	7340 W COLLEGE DR
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1159
Country	:	US
Telephone Number	:	708-361-3233
Fax Number	:	708-361-4876

Authorized Official
Title or Position	:	BOARD MEMBER
Name	:	CHRISTOPHER FARLEY
Credential	:
Telephone Number	:	708-361-7800

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	09/09/2025

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