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Organization

WESTMONT SURGERY CENTER LLC

Active
Other names
Salt Creek Surgery Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARC FAJARDO M.D. (ADMINISTRATOR)
(630) 794-8671
Entity
Organization

Contact information

Practice address
530 N CASS AVE, WESTMONT, IL 60559-1503
(630) 869-4212
(630) 794-8662
Mailing address
530 N CASS AVE, WESTMONT, IL 60559-1503
(630) 869-4212
(630) 794-8662

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7002587
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
490005583
RAILROAD MEDICARE
IL
Enumeration date
12/15/2006
Last updated
04/28/2016
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