Organization
NOVAMED SURGERY CENTER OF OAK LAWN, LLC
Active
Other names
EyeSouth Surgery Center at Oak Lawn
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE B DAVIS (CHIEF REVENUE CYCLE OFFICER)
(916) 990-7590
Entity
Organization
Contact information
Practice address
6311 W 95TH ST, OAK LAWN, IL 60453-2201
(708) 499-3355
(708) 425-5654
Mailing address
6311 W 95TH ST, OAK LAWN, IL 60453-2201
(708) 499-3355
(708) 425-5654
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7002843
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00163716
RR MEDICARE
—
Enumeration date
07/27/2005
Last updated
09/11/2024
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