Ambulatory Surgical Care Facility, LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Aurora, IL
NPI 1497055032 · NPPES record last updated Oct 29, 2010
Key facts
- NPI
- 1497055032
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- AMBULATORY SURGICAL CARE FACILITY, LLC
- Practice address
- 1281 N Farnsworth Ave
Aurora, IL 60505-2445 - Phone
- (773) 283-3131
- NPI assigned
- Oct 29, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Derrick D Wallery, D.C.
- Title
- Ceo / President
- Phone
- (773) 283-3131
Practitioners 1
-
Fernando Perez, D.C.
National Provider Directory
Locations
1281 N Farnsworth Ave
Aurora, IL 60505
Phone (773) 283-3131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
1281 N Farnsworth Ave
Aurora, IL 60505-2445
Mailing address
4176 W Montrose Ave
Chicago, IL 60641-2161
Phone (773) 283-3131
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.