OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS LLC NPI 1497314181

NPI Information

NPI: 1497314181
Provider Name: OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 14D2181050

Address:
1300 N ARLINGTON HEIGHTS RD STE 150
ITASCA, IL
ZIP 60143
Phone: (630) 634-2980
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OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS, LLC is an ambulatory surgical clinic center in Itasca, IL. OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS, LLC NPI is 1497314181. The provider is registered as an organization entity type.

The provider's business location address is:

1300 N ARLINGTON HEIGHTS RD STE 150
ITASCA, IL
ZIP 60143-128
Phone: (630) 634-2980
Fax: (630) 625-8116

The provider's authorized official is Kevin J Kovach .
The authorized official title is President and has the following contact phone number (630) 634-2980.

The CLIA number assigned to this NPI record is 14D2181050 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/6/2019 and was last updated on 8/3/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	248002884	OTHER	ILLINOIS	AMBULATORY SURGICAL CENTER LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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