| NPI | 1780886796 |
|---|---|
| Doing Business As | LAKESIDE SURGERY CENTER |
| Entity Type | Organization |
| Authorized Contact | NATALLIA KASMOUSKAYA Owner /Manager 708-717-6837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IN 17-003259-1) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2018-07-18 |