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Organization
FULLERTON SURGERY CENTER LTD
Active
Organization
FULLERTON SURGERY CENTER LTD
Active
Other names
FULLERTON SURGERY CENTER INC
Organization subpart
No
Provider details
NPI number
Authorized official
NASER RUSTOM M.D. (OWNER/MEDICAL DIRECTOR)
(773) 237-2900
Entity
Organization
Contact information
Practice address
4849 W FULLERTON AVE, CHICAGO, IL 60639-2503
(773) 237-2900
(773) 622-0769
Mailing address
4849 W FULLERTON AVE, CHICAGO, IL 60639-2503
(773) 237-2900
(773) 622-0769
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
042618689
IL
Other
Enumeration date
06/09/2006
Last updated
02/06/2018
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