Organization
ADVANTAGE SURGICAL ASSISTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI SHORTNESS (DIRECTOR OF OPERATIONS)
(630) 421-1191
Entity
Organization
Contact information
Practice address
222 PADDINGTON LN, BOLINGBROOK, IL 60440-4533
(630) 421-1191
(630) 637-0233
Mailing address
222 PADDINGTON LN, BOLINGBROOK, IL 60440-4533
(630) 421-1191
(630) 637-0233
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
238000042
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881775880
BLUE CROSS
IL
Enumeration date
02/10/2012
Last updated
02/10/2012
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