Organization
FULLERTON SURGERY CENTER LTD
Active
Other names
FULLERTON SURGERY CENTER INC
Organization subpart
No
Provider details
NPI number
Authorized official
NASER RUSTOM M.D. (OWNER/MEDICAL DIRECTOR)
(773) 237-2900
Entity
Organization
Contact information
Practice address
4849 W FULLERTON AVE, CHICAGO, IL 60639-2503
(773) 237-2900
(773) 622-0769
Mailing address
4849 W FULLERTON AVE, CHICAGO, IL 60639-2503
(773) 237-2900
(773) 622-0769
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
042618689
IL
Other
Enumeration date
06/09/2006
Last updated
02/06/2018
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