Provider Demographics
NPI:1275705790
Name:MIDWEST SURGICAL SUITES, LTD
Entity type:Organization
Organization Name:MIDWEST SURGICAL SUITES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-622-3350
Mailing Address - Street 1:117 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1006
Mailing Address - Country:US
Mailing Address - Phone:630-622-3350
Mailing Address - Fax:630-582-3316
Practice Address - Street 1:117 W LAKE ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1006
Practice Address - Country:US
Practice Address - Phone:630-622-3350
Practice Address - Fax:630-582-3316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric