NPIMap

Organization Active NPI

ENT Surgical Associates

  • Otolaryngology Physician
  • Joliet, IL
National Provider Identifier
1093753550
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
ENT SURGICAL ASSOCIATES
Practice address
3077 W Jefferson St
Suite 206
Joliet, IL 60435-5262
Phone
(815) 744-2500
Fax
(815) 744-3550
NPI assigned
Jun 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kenneth Paul Jesunas, M.D.NPI 1790723799
Title
President
Phone
(815) 744-2500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

3077 W Jefferson St
Suite 206
Joliet, IL 60435-5262

Mailing address

3077 W Jefferson St
Suite 206
Joliet, IL 60435-5262
Phone (815) 744-2500

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093753550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3077 W JEFFERSON ST",
            "address_2": "SUITE 206",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355262",
            "telephone_number": "815-744-2500",
            "fax_number": "815-744-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 W JEFFERSON ST",
            "address_2": "SUITE 206",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355262",
            "telephone_number": "815-744-2500",
            "fax_number": "815-744-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JESUNAS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-744-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.