# THORACIC SURGICAL ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225528979
- **Authorized official:** DR. PAUL GORDON MD (PRESIDENT)
- **Authorized official phone:** (708) 346-4065

## Contact information

- **Practice address:** 10604 SOUTHWEST HIGHWAY, SUITE 101, CHICAGO RIDGE, IL 60415
- **Practice address phone:** (708) 346-4065
- **Practice address fax:** (708) 423-5799
- **Mailing address:** 10604 SOUTHWEST HIGHWAY, SUITE 101, CHICAGO RIDGE, IL 60415
- **Mailing address phone:** (708) 346-4065
- **Mailing address fax:** (708) 423-5799

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | PENDING | IL | Yes |

## Other

- **Enumeration date:** 05/17/2018
- **Last updated:** 05/17/2018