Organization
METROPOLITAN SURGICAL ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEJANDRA PEREZ- TAMAYO MD (DELEGATED OFFICIAL)
(312) 567-2199
Entity
Organization
Contact information
Practice address
2525 S MICHIGAN AVE, 2ND FLOOR, DOCTORS OFFICE CENTER, CHICAGO, IL 60616-2333
(312) 567-2199
(312) 328-7720
Mailing address
777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
(630) 789-2550
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21622027
BCBS PROVIDER ID
IL
01
—
CG5826
RAILROAD MEDICARE
IL
01
—
CK2946
RAILROAD MEDICARE
IL
Enumeration date
05/01/2006
Last updated
01/04/2008
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