Hyde Park Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

HYDE PARK SURGERY CENTER, LLC

Practice address

1644 E 53Rd St
Chicago, IL 60615-4210

Phone

(773) 752-2111

Fax

(773) 752-6703

NPI assigned

Aug 22, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Fortunee Massuda, DPM

Title

Medical Director & Ceo

Phone

(773) 752-2111

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258934400000",
    "number": "1609868041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9933 S WESTERN AVE",
            "address_2": "SUITE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431810",
            "telephone_number": "773-233-3800",
            "fax_number": "773-233-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 E 53RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154210",
            "telephone_number": "773-752-2111",
            "fax_number": "773-752-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2009-11-23",
        "status": "A",
        "authorized_official_last_name": "MASSUDA",
        "authorized_official_first_name": "FORTUNEE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR & CEO",
        "authorized_official_telephone_number": "773-752-2111",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "50460",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hyde Park Dental Profile
• Hyde Park Foot Care PLLC
• Hyde Park Medical Specialty Group, LLC
• Hyde Park Mental Wellness
• Hyde Park Podiatry Ctr LTD
• Hyde Park Surgical Center LLC
• Hyde Park Universal Dental LLC
• Hyde Park Universal Dental LLC
• Hyde Park Village Nursing & Rehabilitation Center LLC
• Hyde Park Vision Center LTD.

• Ambulatory Surgical Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.