Organization
ELMWOOD PARK SAME DAY SURGERY LLC
Active
Other names
SameDay Surgery Elmwood Park
Organization subpart
No
Provider details
NPI number
Authorized official
KIM ZIDONIS (ADMINISTRATOR)
(312) 573-5800
Entity
Organization
Contact information
Practice address
1614 N HARLEM AVE, ELMWOOD PARK, IL 60707-4302
(708) 452-5000
(708) 452-5588
Mailing address
1614 N HARLEM AVE, ELMWOOD PARK, IL 60707-4302
(708) 452-5000
(708) 452-5588
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7002387
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50405
BCBS
ID
Enumeration date
02/14/2007
Last updated
06/27/2012
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