Organization
ADVA-MED SURGICAL ASSOCIATION INC
Active
Other names
NCDS Ambulatory Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MAGDALENA MIETUS (OFFICE MANAGER)
(708) 636-8546
Entity
Organization
Contact information
Practice address
4201 W 95TH ST, OAK LAWN, IL 60453-2615
(708) 636-7870
(708) 636-0264
Mailing address
4201 W 95TH ST, OAK LAWN, IL 60453-2615
(708) 636-7870
(708) 636-0264
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/09/2007
Last updated
08/22/2020
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