| Chicago Surgical Specialists, Llc | |
|
22 S Washington Ave Park Ridge IL 60068-4267 | |
| (847) 268-3910 | |
| (847) 897-3118 |
| Full Name | Chicago Surgical Specialists, Llc |
|---|---|
| Speciality | Dentist |
| Location | 22 S Washington Ave, Park Ridge, Illinois |
| Authorized Official Name and Position | Anthony M. Spina (OWNER) |
| Authorized Official Contact | 8472683910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Surgical Specialists, Llc 22 S Washington Ave Park Ridge IL 60068-4267 Ph: (847) 268-3910 | Chicago Surgical Specialists, Llc 22 S Washington Ave Park Ridge IL 60068-4267 Ph: (847) 268-3910 |
| NPI Number | 1235560178 |
|---|---|
| Provider Enumeration Date | 12/03/2013 |
| Last Update Date | 06/04/2020 |
| Medicare PECOS PAC ID | 1254561426 |
|---|---|
| Medicare Enrollment ID | O20140310000212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235560178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Victor Cimino |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1194792911 PECOS PAC ID: 0547167389 Enrollment ID: I20031218000431 |
| Provider Name | Anthony M Spina |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1508850272 PECOS PAC ID: 1951384064 Enrollment ID: I20101018000168 |
| Provider Name | Mariusz Wrzosek |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1144274853 PECOS PAC ID: 1153574264 Enrollment ID: I20150910002360 |
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