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Contact Information

BMI SURGERY SC
1890 SILVER CROSS BLVD
SUITE 260
NEW LENOX, IL60451-9524
 Phone: 815-717-8744
 Fax: 815-717-8339
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for BMI SURGERY SC · (Female)

NPI # 1578765210
Status Active
Credentials
Entity Individual
Enumeration date 06/04/2007
Last updated 01/21/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 036077839
  • IL Medicaid 036077839
  • IL Medicaid 036111197
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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