Organization
SURGICAL ASSOCIATES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LUZ LOPEZ (OFFICE MANAGER)
(847) 869-0522
Entity
Organization
Contact information
Practice address
800 AUSTIN ST, EAST TOWER SUITE 563, EVANSTON, IL 60202-3439
(847) 869-0522
Mailing address
800 AUSTIN ST, EAST TOWER SUITE 563, EVANSTON, IL 60202-3439
(847) 869-0522
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036059121
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-059121
—
IL
01
—
31600566
BCBS OF IL
IL
Enumeration date
04/02/2008
Last updated
04/02/2008
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