Organization
CENTRAL ILLINOIS SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARSHALL F BRUSTEIN M.D. (PRESIDENT, BOARD OF DIRECTORS)
(217) 872-8204
Entity
Organization
Contact information
Practice address
304 W HAY ST, SUITE 114, DECATUR, IL 62526-6328
(217) 876-8201
(217) 876-8202
Mailing address
304 W HAY ST, SUITE 114, DECATUR, IL 62526-6328
(217) 876-8201
(217) 876-8202
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7002819
IL
Other
Enumeration date
03/14/2006
Last updated
08/22/2020
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