Organization
PROGRESSIVE SURGICAL ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REZA GAMAGAMI MD (OWNER)
(815) 717-8730
Entity
Organization
Contact information
Practice address
1890 SILVER CROSS BLVD, SUITE 410, NEW LENOX, IL 60451-9524
(815) 717-8730
(815) 717-8729
Mailing address
1890 SILVER CROSS BLVD, SUITE 410, NEW LENOX, IL 60451-9524
(815) 717-8730
(815) 717-8729
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036103521
IL
Other
Enumeration date
07/09/2009
Last updated
08/09/2012
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