NPIMap

Organization Active NPI

Suburban Orthopaedics

  • Orthopaedic Surgery Physician
  • Elgin, IL
National Provider Identifier
1063737658
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036064932 Issued in IL
Legal business name
SUBURBAN ORTHOPAEDICS
Practice address
1600 N Randall Rd
Elgin, IL 60123-7800
Phone
(630) 372-1100
Fax
(630) 372-6230
NPI assigned
Apr 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Authorized official

Name
Edward Ortiz
Title
Practice & Compliance Administrator
Phone
(630) 372-1100

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038007742 IL
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X 036064932 IL Primary
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X 036097451 IL
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 070012618 IL
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 085001660 IL
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 085002852 IL

Addresses

Primary practice location

1600 N Randall Rd
Elgin, IL 60123-7800

Mailing address

1110 W Schick Rd
Bartlett, IL 60103-3007
Phone (630) 372-1100

Other identifiers 2

IdentifierTypeStateIssuer
01626816OtherILBCBS
036064932MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Suburban Orthopedics LT7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1063737658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W SCHICK RD",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601033007",
            "telephone_number": "630-372-1100",
            "fax_number": "630-372-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237800",
            "telephone_number": "630-372-1100",
            "fax_number": "630-372-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN ORTHOPAEDICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-07",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRACTICE & COMPLIANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "630-372-1100"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038007742",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036064932",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "IL",
            "license": "036097451",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "070012618",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001660",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002852",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01626816",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064932",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.