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Organization
SURGICAL PARTNERS
Active
Organization
SURGICAL PARTNERS
Active
Other names
Broad Enterprises, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YASER A MAKSOUD M.D. (PRESIDENT AND CEO)
(312) 731-4949
Entity
Organization
Contact information
Practice address
4440 W 95TH ST, ADVOCATE MEDICAL GROUP - SURGICAL PARTNERS, OAK LAWN, IL 60453-2600
(312) 731-4949
Mailing address
PO BOX 437, SURGICAL PARTNERS, CHICAGO RIDGE, IL 60415-0437
(312) 731-4949
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
238.000220
IL
Other
Enumeration date
08/03/2011
Last updated
08/03/2011
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