# VASCULAR ACCESS CENTERS OF ILLINOIS AT MORGAN PARK, LLC

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

## Provider details

- **NPI number:** 1689163875
- **Authorized official:** AMITABHA MITRA (PRESIDENT)
- **Authorized official phone:** (312) 654-2720

## Contact information

- **Practice address:** 1701 W MONTEREY AVE, CHICAGO, IL 60643-4257
- **Practice address phone:** (773) 366-8035
- **Practice address fax:** (773) 881-1214
- **Mailing address:** 210 S DES PLAINES ST, CHICAGO, IL 60661-5500
- **Mailing address phone:** (312) 654-2721
- **Mailing address fax:** (866) 954-5804

## Taxonomy

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

## Other

- **Enumeration date:** 05/03/2018
- **Last updated:** 11/22/2024