Organization
ELMHURST MEDICAL & SURGICAL CENTER CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEN GRIMES (ADMINISTRATOR)
(630) 495-1240
Entity
Organization
Contact information
Practice address
340 W BUTTERFIELD RD STE 1B, ELMHURST, IL 60126-5047
(630) 495-1240
(630) 495-1993
Mailing address
6 E SAINT CHARLES RD STE 100, LOMBARD, IL 60148-2302
(630) 495-1240
(630) 495-1993
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7003154
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14C0001151
CMS CERTIFICATION NUMBER
IL
Enumeration date
11/19/2010
Last updated
02/28/2013
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