# LOGAN SQUARE SURGERY CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LOGAN SQUARE SURGERY CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508058934
- **Authorized official:** TERRI NASSAR (MANAGER)
- **Authorized official phone:** (773) 227-3950

## Contact information

- **Practice address:** 2004 N PULASKI RD, CHICAGO, IL 60639-3767
- **Practice address phone:** (773) 227-3950
- **Practice address fax:** (773) 252-3050
- **Mailing address:** 2006 N PULASKI RD, CHICAGO, IL 60639-3767
- **Mailing address phone:** (773) 227-3950
- **Mailing address fax:** (773) 252-3050

## Taxonomy

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

## Other

- **Enumeration date:** 08/09/2007
- **Last updated:** 08/09/2007