Organization
APAC SURGICAL CENTER II, LLC
Active
Other names
APAC Surgery Center II LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FAISAL M RAHMAN PH.D. (CEO)
(219) 865-3819
Entity
Organization
Contact information
Practice address
11460 S. BROADWAY ST., CROWN POINT, IN 46307-7106
(219) 488-0155
(219) 865-5401
Mailing address
425 JOLIET ST., SUITE 400, DYER, IN 46311-1768
(219) 227-3622
(219) 865-5401
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
06-002683-3
IN
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
11-002683-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000194412
BCBS OF INDIANA
IN
05
—
200321120
—
IN
Enumeration date
06/23/2006
Last updated
04/15/2011
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