Silver Cross Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SILVER CROSS AMBULATORY SURGERY CENTER, LLC

Practice address

1003 Pawlak Parkway
New Lenox, IL 60451

Phone

(815) 717-1740

Fax

(815) 320-3240

NPI assigned

Apr 24, 2017

Organization subpart

No

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

Authorized official

Name

Jonathan Bailey

Title

Authorized Official

Phone

(203) 609-1168

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Silver Cross Surgery Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Silver Cross Ambulatory Surgery Center LLC Dba Silver Cross Surgery CenterCCN 14C0001172

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Silver Cross Hospital & Medical Centers

  • Home Health Agency
  • New Lenox, IL
  • NPI 1265558852

  Member Of

  NPD member
• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

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

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1063947422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 PAWLAK PARKWAY",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "60451",
            "telephone_number": "815-717-1740",
            "fax_number": "815-320-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 PAWLAK PARKWAY",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "60451",
            "telephone_number": "815-717-1740",
            "fax_number": "815-320-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER CROSS AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-24",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "203-609-1168"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "7003216",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "F300456180",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Silver Cross Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Silver Cross Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamie Shefcik
• Michele Shelly, LCSW, CCTP, CSTS
• Sidra Shoaib, LPC
• Ahmad Shoubaki, MD
• Juwayne Lemonte Silmon Sr., MSW
• Silver Cross Health Connection, LLC
• Silver Cross Hospital & Medical Centers
• Silver Cross Hospital & Medical Centers
• Silver Cross Hospital & Medical Centers
• Silver Cross Hospital & Medical Centers

• All providers in New Lenox, IL
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.