Innovia Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

7002140 Issued in IL

Legal business name

INNOVIA SURGERY CENTER, LLC

Practice address

203 E Irving Park Rd
Wood Dale, IL 60191-2045

Phone

(630) 595-1515

NPI assigned

Feb 20, 2007

Last updated

May 22, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vera Schmidt

Title

Administrator

Phone

(847) 385-0700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advantage Healthcare Former legal business name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023153160. Details of each certification follow.

• CCN 14C0001179 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 14C0001179

Legal name

Innovia Surgery Center, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jul 31, 2019

Last certification

Jul 31, 2019

Ownership / control type

Proprietary

Facility address

203 E Irving Park Rd
Wood Dale, IL 60191

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vijay L Goyal, M.D.

  • Family Medicine Physician
  • Arlington Heights, IL
  • NPI 1306990080
  NPD
• Vinay Goyal, D.O.

  • Otolaryngology Physician
  • Elgin, IL
  • NPI 1912439951
  NPD (past)
• Sheela Saidha, M.D.

  • Otolaryngology Physician
  • Elgin, IL
  • NPI 1770015984
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1023153160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E IRVING PARK RD",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601912045",
            "telephone_number": "847-385-0700",
            "fax_number": "877-550-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E IRVING PARK RD",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601912045",
            "telephone_number": "630-595-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVIA SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "VERA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-385-0700"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7002140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "1535",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Healthcare",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Illinois Neuro & Physical Rehabilitation LTD
• Institute for Cardiothoracic & Vein Surgery LLC
• Tina Santana Johanson
• Allison V Johnson, M.S., CF-SLP
• Borislav Denkov Kaltchev, D.M.D.
• Karing Dental Center

• Ambulatory Surgical Clinic/Center in Wood Dale, IL
• Providers in Wood Dale, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.