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Organization

NORTHWEST SUBURBAN SURGICAL SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RONALD JAY LEIB (OWNER)
(815) 477-8911
Entity
Organization

Contact information

Practice address
39 S VIRGINIA ST, SUITE 200, CRYSTAL LAKE, IL 60014-5826
(815) 477-8911
(815) 477-8911
Mailing address
39 S VIRGINIA ST, SUITE 200, CRYSTAL LAKE, IL 60014-5826
(815) 477-8911
(815) 477-8911

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
01/24/2007
Last updated
08/22/2020
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