Organization
CENTER FOR SOUTHSIDE SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA MANDABACH (DIRECTOR OF BUSINESS OPS)
(317) 706-7246
Entity
Organization
Contact information
Practice address
533 E COUNTY LINE RD, SUITE 201, GREENWOOD, IN 46143-1073
(317) 706-7246
(317) 706-3419
Mailing address
29945 NETWORK PL, CHICAGO, IL 60673-1299
(317) 706-7246
(317) 706-3419
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201358590A
—
IN
Enumeration date
08/07/2015
Last updated
11/18/2025
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