# GRAND OAKS SURGICAL, S.C.

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

## Provider details

- **NPI number:** 1588729396
- **Authorized official:** DR. BRUCE W. IRWIN M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (847) 549-1176

## Contact information

- **Practice address:** 1800 HOLLISTER DR, SUITE 204, LIBERTYVILLE, IL 60048-5263
- **Practice address phone:** (847) 549-1176
- **Mailing address:** PO BOX 5667, VERNON HILLS, IL 60061-5667
- **Mailing address phone:** (847) 549-1176

## Taxonomy

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

## Other

- **Enumeration date:** 12/22/2006
- **Last updated:** 08/22/2020