Organization
NORTHEAST DUPAGE SURGERY CENTER, LLC
Active
Other names
Suburban Surgery Center of DuPage
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY J FATO MBA, CASC (BUSINESS ADMINISTRATOR)
(630) 505-3383
Entity
Organization
Contact information
Practice address
1580 W LAKE ST, ADDISON, IL 60101-1171
(630) 285-7000
(630) 799-0223
Mailing address
75 REMITTANCE DR, SUITE 3279, CHICAGO, IL 60675-1001
(630) 285-7000
(630) 799-0223
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7002496
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7002496
STATE LICENSE
IL
Enumeration date
10/05/2006
Last updated
08/22/2020
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