WESTERN AVENUE SURGICAL ASSOCIATES, LLC
NPI 1285859595
Clinic/Center - Ambulatory Surgical in Chicago, IL

Active since April 13, 2007
712 N DEARBORN ST, CHICAGO, IL 60654(312) 981-1297 Get Directions Write a Review

NPPES record last updated: May 6, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Clinic/Center
  • Ambulatory Surgical

About WESTERN AVENUE SURGICAL ASSOCIATES, LLC

This page provides the complete NPI Profile along with additional information for Western Avenue Surgical Associates, Llc, a provider established in Chicago, Illinois operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1285859595 assigned on April 2007. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 17 years ago. The authorized official of this NPI record is Dr. Gary Wiesman M.d. (Co-owner)

NPI
1285859595 Verify this NPI
Provider Name
WESTERN AVENUE SURGICAL ASSOCIATES, LLC
Entity Type
Organization
Location Address
712 N DEARBORN ST CHICAGO, IL 60654
Location Phone
(312) 981-1297
Mailing Address
712 N DEARBORN ST CHICAGO, IL 60654
Mailing Phone
(312) 981-1297
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-13-2007
Last Update Date
05-06-2009
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. GARY WIESMAN M.D.

Authorized Official Title
CO-OWNER
Authorized Official Phone
(312) 981-1297

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Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Pain Medicine (Pain Medicine)
712 N DEARBORN ST
CHICAGO, IL 60654
Durable Medical Equipment & Medical Supplies
712 N DEARBORN ST
CHICAGO, IL 60654
Surgery (Plastic and Reconstructive Surgery)
712 N DEARBORN ST
CHICAGO, IL 60654
Pain Medicine (Interventional Pain Medicine)
712 N DEARBORN ST, SUITE 200
CHICAGO, IL 60654
Dentist (General Practice)
712 N DEARBORN ST
CHICAGO, IL 60654
Neuromusculoskeletal Medicine, Sports Medicine
712 N DEARBORN ST
CHICAGO, IL 60654
Dentist (General Practice)
712 N DEARBORN ST, 4TH FLOOR
CHICAGO, IL 60654
Physician Assistant
712 N DEARBORN ST
CHICAGO, IL 60654
Clinic/Center (Health Service)
712 N DEARBORN ST
CHICAGO, IL 60654
Occupational Therapist
712 N DEARBORN ST
CHICAGO, IL 60654
Plastic Surgery
712 N DEARBORN ST
CHICAGO, IL 60654
Surgery (Plastic and Reconstructive Surgery)
712 N DEARBORN ST
CHICAGO, IL 60654
Anesthesiology
712 N DEARBORN ST
CHICAGO, IL 60654
Pharmacy (Community/Retail Pharmacy)
712 N DEARBORN ST, STE. 3A
CHICAGO, IL 60654
Specialist/Technologist, Other (Surgical Technologist)
712 N DEARBORN ST
CHICAGO, IL 60654
Anesthesiology
712 N DEARBORN ST
CHICAGO, IL 60654
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
712 N DEARBORN ST
CHICAGO, IL 60654
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
712 N DEARBORN ST
CHICAGO, IL 60654
Physician Assistant
712 N DEARBORN ST
CHICAGO, IL 60654
Physical Therapist
712 N DEARBORN ST
CHICAGO, IL 60654

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285859595, enumerated as an "organization" on April 13, 2007.

The provider is located at 712 N DEARBORN ST CHICAGO, IL 60654 and the phone number is (312) 981-1297.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.