Organization
SUBURBAN METABOLIC INSTITUTE, LLC
Active
Parent organization
SUBURBAN SURGICAL ASSOCIATES, LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUBURBAN SURGICAL ASSOCIATES, LTD
Authorized official
DR. RYAN C. HEADLEY M.D. (GENERAL SURGEON)
(708) 484-0621
Entity
Organization
Contact information
Practice address
908 N ELM ST STE 309, HINSDALE, IL 60521-3625
(708) 484-0621
(708) 484-0250
Mailing address
908 N ELM ST STE 309, HINSDALE, IL 60521-3625
(708) 484-0621
(708) 484-0250
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036114720
IL
174400000X
Specialist
036118355
IL
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03611470
—
IL
Enumeration date
05/25/2010
Last updated
11/01/2024
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