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Organization
CDN SURGICAL ASSOC., LTD.
Active
Organization
CDN SURGICAL ASSOC., LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN URSO (MEDICAL BILLING MANAGER)
(773) 763-3445
Entity
Organization
Contact information
Practice address
2913 N COMMONWEALTH AVE, CHICAGO, IL 60657-6211
(773) 472-3427
(773) 472-8561
Mailing address
PO BOX 597995, CHICAGO, IL 60695-0001
(773) 472-3427
(773) 472-8561
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
IL
2086X0206X
Surgical Oncology Physician
—
IL
208C00000X
Colon & Rectal Surgery Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001618161
BC BS OF IL GROUP NUMBER
IL
01
—
CA6608
MEDICARE RAILROAD PART B
IL
Enumeration date
01/25/2007
Last updated
12/21/2007
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