Organization Name: | MIDWEST SURGICAL ASSOCIATES, S.C. |
NPI Number: | 1881729879 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | COLLEEN ANN HAGEN (PRESIDENT) |
Mailing Address: | 5201 Willow Springs Rd Suite 180 La Grange Highlands |
State: | IL US |
Postal Code: | 605256537 |
Phone Number: | 7085799705 |
Fax Number: | 7085790346 |
NPI Enumeration Date: | 02/22/2007 |
NPI Last Update Date: | 07/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 036-053291 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |