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Organization

HINSDALE SURGICAL CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER HARTSHORN (OFFICER / AUTHORIZED OFFICIAL)
(314) 800-2017
Entity
Organization

Contact information

Practice address
10 SALT CREEK LANE, HINSDALE, IL 60521
(630) 325-5035
(630) 325-5134
Mailing address
14201 DALLAS PKWY, DALLAS, TX 75254-2916
(630) 325-5035
(630) 325-5134

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7002314
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1532
BCBS
IL
01
490004574
RAILROAD MEDICARE
IL
Enumeration date
06/16/2006
Last updated
12/01/2020
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