Organization
RIVER FOREST SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA GILL (ADMINISTRATOR)
(708) 771-3334
Entity
Organization
Contact information
Practice address
7427 LAKE ST, RIVER FOREST, IL 60305-1817
(708) 488-1200
(708) 771-7321
Mailing address
7427 LAKE ST, RIVER FOREST, IL 60305-1817
(708) 488-1200
(708) 771-0841
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7002561
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490005430
RR MEDICARE
—
Enumeration date
08/09/2005
Last updated
03/30/2018
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