| Organization Name: | NORTHEAST DUPAGE SURGERY CENTER, LLC |
| NPI Number: | 1073609368 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANTHONY J FATO (BUSINESS ADMINISTRATOR) |
| Mailing Address: | 1580 W Lake St Addison |
| State: | IL US |
| Postal Code: | 601011171 |
| Phone Number: | 6302857000 |
| Fax Number: | 6307990223 |
| NPI Enumeration Date: | 10/05/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 7002496 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |