Organization
CUSTOM SURGICAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA OSIPOVA MD (PRESIDENT)
(773) 551-5776
Entity
Organization
Contact information
Practice address
2350 RAVINE WAY STE 400, GLENVIEW, IL 60025-7621
(847) 232-4843
(847) 779-6877
Mailing address
1S376 SUMMIT AVE STE 4C, OAKBROOK TERRACE, IL 60181-3966
(847) 232-4843
(847) 779-6877
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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