Provider Demographics
NPI:1306977061
Name:ELMHURST MEDSURGE LTD
Entity type:Organization
Organization Name:ELMHURST MEDSURGE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:TSATSOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-530-8600
Mailing Address - Street 1:401 N YORK ST
Mailing Address - Street 2:UL2
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5510
Mailing Address - Country:US
Mailing Address - Phone:630-530-8600
Mailing Address - Fax:630-203-1640
Practice Address - Street 1:401 N YORK ST
Practice Address - Street 2:UL2
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5510
Practice Address - Country:US
Practice Address - Phone:630-530-8600
Practice Address - Fax:630-203-1640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical