Organization
MAKER SURGICAL, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAY K. MAKER M.D., F.A.C.S. (PRESIDENT/OWNER)
(773) 296-5346
Entity
Organization
Contact information
Practice address
3000 N HALSTED ST, SUITE 500, CHICAGO, IL 60657-5188
(773) 296-5346
(773) 296-5570
Mailing address
1055 HILLCREST RD, GLENCOE, IL 60022-1215
(773) 296-5346
(773) 296-5570
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036045277
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036045277
—
IL
01
—
222350
PTAN
IL
Enumeration date
06/03/2011
Last updated
06/03/2011
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