Organization
INGALLS SAME DAY SURGERY CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JO CRANDALL (VICE PRESIDENT)
(708) 915-3062
Entity
Organization
Contact information
Practice address
6701 159TH ST, LOWER LEVEL, TINLEY PARK, IL 60477-1758
(708) 429-0222
(708) 429-0293
Mailing address
PO BOX 735078, CHICAGO, IL 60673-5078
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
7001043
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
535
BLUECROSS BLUESHIELD
IL
Enumeration date
07/17/2006
Last updated
05/07/2025
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