Organization
SURGERY GROUP SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI KRUSELY (ACCOUNT MANAGER)
(847) 838-3832
Entity
Organization
Contact information
Practice address
1665 SOUTH ST, GENEVA, IL 60134-2542
(630) 208-7874
(630) 208-7880
Mailing address
1665 SOUTH ST, GENEVA, IL 60134-2542
(630) 208-7874
(630) 208-7880
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
10/24/2006
Last updated
11/08/2012
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