# CDN SURGICAL ASSOC., LTD.

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

## Provider details

- **NPI number:** 1528114501
- **Authorized official:** MRS. KAREN URSO (MEDICAL BILLING MANAGER)
- **Authorized official phone:** (773) 763-3445

## Contact information

- **Practice address:** 2913 N COMMONWEALTH AVE, CHICAGO, IL 60657-6211
- **Practice address phone:** (773) 472-3427
- **Practice address fax:** (773) 472-8561
- **Mailing address:** PO BOX 597995, CHICAGO, IL 60695-0001
- **Mailing address phone:** (773) 472-3427
- **Mailing address fax:** (773) 472-8561

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | IL | Yes |
| 2086X0206X | Surgical Oncology Physician | — | IL | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | IL | — |

## Other

- **Enumeration date:** 01/25/2007
- **Last updated:** 12/21/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0001618161 | BC BS OF IL GROUP NUMBER | IL |
| 01 | — | CA6608 | MEDICARE RAILROAD PART B | IL |