Provider Demographics
NPI:1265737621
Name:ILLINOIS HAND & UPPER EXTREMITY CENTER, L.L.C.
Entity type:Organization
Organization Name:ILLINOIS HAND & UPPER EXTREMITY CENTER, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:I
Authorized Official - Last Name:VENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-956-0099
Mailing Address - Street 1:515 W ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4405
Mailing Address - Country:US
Mailing Address - Phone:847-956-0099
Mailing Address - Fax:847-956-0433
Practice Address - Street 1:515 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4405
Practice Address - Country:US
Practice Address - Phone:847-956-0099
Practice Address - Fax:847-956-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical