Provider Demographics
NPI:1447335948
Name:SUBURBAN SURGICAL SERVICES
Entity type:Organization
Organization Name:SUBURBAN SURGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SALVADOR
Authorized Official - Middle Name:
Authorized Official - Last Name:YUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-550-0040
Mailing Address - Street 1:900 W. ROUTE 22
Mailing Address - Street 2:SUITE 120A
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-3416
Mailing Address - Country:US
Mailing Address - Phone:847-550-0040
Mailing Address - Fax:847-550-0022
Practice Address - Street 1:900 W. ROUTE 22
Practice Address - Street 2:SUITE 120A
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-3416
Practice Address - Country:US
Practice Address - Phone:847-550-0040
Practice Address - Fax:847-550-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILD6144-486-6261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD6144-486-6OtherCORP #