Provider Demographics
NPI:1366782583
Name:METRO CHICAGO SURGICAL ONCOLOGY LLC
Entity type:Organization
Organization Name:METRO CHICAGO SURGICAL ONCOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-673-6505
Mailing Address - Street 1:3201 OLD GLENVIEW RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2999
Mailing Address - Country:US
Mailing Address - Phone:847-673-6505
Mailing Address - Fax:847-673-2099
Practice Address - Street 1:3201 OLD GLENVIEW RD
Practice Address - Street 2:SUITE 205
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2999
Practice Address - Country:US
Practice Address - Phone:847-673-6505
Practice Address - Fax:847-673-2099
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METRO CHICAGO SURGICAL ONCOLOGY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-25
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036111584291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036111584OtherLICENSE