Provider Demographics
NPI:1548538192
Name:SURGICAL ASSISTING SOLUTIONS, LLC
Entity type:Organization
Organization Name:SURGICAL ASSISTING SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:TEODORO
Authorized Official - Suffix:
Authorized Official - Credentials:RSA
Authorized Official - Phone:708-602-2183
Mailing Address - Street 1:16525 W 159TH ST
Mailing Address - Street 2:#140
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-7900
Mailing Address - Country:US
Mailing Address - Phone:708-602-2183
Mailing Address - Fax:815-600-8637
Practice Address - Street 1:16525 W 159TH ST
Practice Address - Street 2:#140
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-7900
Practice Address - Country:US
Practice Address - Phone:708-602-2183
Practice Address - Fax:815-600-8637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-11
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL238.000243174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty