| Organization Name: | THE MEDICAL & SURGICAL CENTER OF ILLINOIS |
| NPI Number: | 1639343049 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAUL POTACH (PRESIDENT) |
| Mailing Address: | 3818 Nottingham Dr Long Grove |
| State: | IL US |
| Postal Code: | 600475240 |
| Phone Number: | 8478083338 |
| Fax Number: | |
| NPI Enumeration Date: | 04/16/2008 |
| NPI Last Update Date: | 04/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP1100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Podiatric |
| Taxonomy Definition: | |