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Organization
HYDE PARK SURGERY CENTER, LLC
Active
Organization
HYDE PARK SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FORTUNEE MASSUDA DPM (MEDICAL DIRECTOR & CEO)
(773) 752-2111
Entity
Organization
Contact information
Practice address
1644 E 53RD ST, CHICAGO, IL 60615-4210
(773) 752-2111
(773) 752-6703
Mailing address
9933 S WESTERN AVE, SUITE 102, CHICAGO, IL 60643-1810
(773) 233-3800
(773) 233-2513
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/22/2005
Last updated
11/23/2009
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