Bridgeport Surgicenter, Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BRIDGEPORT SURGICENTER, INC

Practice address

436 W 31St St
Chicago, IL 60616-3136

Phone

(815) 254-7872

Fax

(815) 254-7873

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Perez, DPM

Title

President

Phone

(815) 254-7872

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1891816450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 W 31ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163136",
            "telephone_number": "815-254-7872",
            "fax_number": "815-254-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 W 31ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163136",
            "telephone_number": "815-254-7872",
            "fax_number": "815-254-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPORT SURGICENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-254-7872",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridgeport Foot Care, LTD
• Bridgeport Pain Control
• Bridgeport Pharmacy Inc
• Bridgeport Physical Wellness LLC
• Bridgeport Smiles
• Bridges Academy, LLC
• Bridges LLC
• Bridges to Wellness
• Danielle Bridges
• Katie Hunt Bridges, DMD

• 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 Jul 21, 2022; 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.