Organization
GREAT LAKES SURGICAL SUITES, LLC
Active
Other names
Great Lakes Surgical Suites
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER HARTSHORN (OFFICER/AUTHORIZED OFFICIAL)
(314) 800-2017
Entity
Organization
Contact information
Practice address
9200 CALUMET AVE STE N500, MUNSTER, IN 46321-2849
(219) 513-9955
(219) 513-9373
Mailing address
14201 DALLAS PKWY, DALLAS, TX 75254-2916
(219) 513-9955
(219) 513-9373
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/18/2017
Last updated
10/07/2024
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