# NORTHEAST DUPAGE SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Suburban Surgery Center of DuPage
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073609368
- **Authorized official:** ANTHONY J FATO MBA, CASC (BUSINESS ADMINISTRATOR)
- **Authorized official phone:** (630) 505-3383

## Contact information

- **Practice address:** 1580 W LAKE ST, ADDISON, IL 60101-1171
- **Practice address phone:** (630) 285-7000
- **Practice address fax:** (630) 799-0223
- **Mailing address:** 75 REMITTANCE DR, SUITE 3279, CHICAGO, IL 60675-1001
- **Mailing address phone:** (630) 285-7000
- **Mailing address fax:** (630) 799-0223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 7002496 | IL | Yes |

## Other

- **Enumeration date:** 10/05/2006
- **Last updated:** 08/22/2020