Organization
WEST SUBURBAN NEUROSURGICAL ASSOCIATES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CAULDEEN M CALMEYN (ADMINISTRATOR)
(630) 655-1229
Entity
Organization
Contact information
Practice address
700 E OGDEN AVE STE 106, WESTMONT, IL 60559-1283
(630) 655-1229
(630) 655-0185
Mailing address
PO BOX 433, WESTMONT, IL 60559-0433
(630) 655-1229
(630) 655-0185
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D 4922-407-9
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-15248
BLUE SHIELD PROVIDER
IL
Enumeration date
02/22/2006
Last updated
07/18/2022
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