# HISPANIC AMERICAN ENDOSCOPY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chicago Surgery Center, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861684458
- **Authorized official:** DR. RYAN ROSENTHAL DC (OWNER)
- **Authorized official phone:** (312) 761-0100

## Contact information

- **Practice address:** 3536 W FULLERTON AVE, CHICAGO, IL 60647-2443
- **Practice address phone:** (773) 772-1212
- **Practice address fax:** (773) 697-8305
- **Mailing address:** 3536 W FULLERTON AVE, CHICAGO, IL 60647-2443
- **Mailing address phone:** (312) 761-0100
- **Mailing address fax:** (773) 697-8305

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 7003126 | IL | Yes |

## Other

- **Enumeration date:** 08/16/2007
- **Last updated:** 04/17/2019