TIESENGA SURGICAL ASSOCIATES, S.C.
Radiology at Harlem Ave, Chicago, IL

License number
Illinois 042000966
Category
Radiology
Type
Surgery
License number
Illinois 042000966
Category
Radiology
Type
Vascular Surgery
Owner
Name: FREDERICK M. TIESENGA M.D.
Title: PRESIDENT
Phone: (708) 453-6800
Address
Address
1950 N Harlem Ave, Chicago, IL 60707
National Provider ID: 1801876586
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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TIESENGA SURGICAL ASSOCIATES, S.C

Elmwood Park, IL 60707

Registration:
Dec 29, 1970
State ID:
49763441
Business type:
DOMESTIC BCA
Expiration:
PERPETUAL
Agent:
Avery Delott,7250 N Cicero Ave, Lincolnwood, IL 60712 (Physical)

Tiesenga Surgical Associates, S.C. Suburban Surge

1950 N Harlem Ave, Elmwood Park, IL 60707

Industry:
Surgeons
Phone:
(708) 453-6800 (Phone)

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