Organization
FULLERTON MEDICAL SURGICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL RAMIREZ D.P.M. (PRESIDENT)
(773) 622-8060
Entity
Organization
Contact information
Practice address
5723 W FULLERTON AVE, CHICAGO, IL 60639-2306
(773) 622-8060
(773) 622-8095
Mailing address
5723 W FULLERTON AVE, CHICAGO, IL 60639-2306
(773) 622-8060
(773) 622-8095
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/27/2006
Last updated
08/22/2020
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