Organization
SUBURBAN SURGICAL ASSOCIATES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY K ZAWACKI M.D. (PRESIDENT)
(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
208600000X
Surgery Physician
Primary
036-079983
IL
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01619787
BCBSIL GROUP NUMBER
—
05
—
PUL3GQNWVE5N
—
IL
Enumeration date
10/24/2005
Last updated
11/01/2024
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