Southwest Head & Neck Surgical Assoc SC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

036054754 Issued in IL

Legal business name

SOUTHWEST HEAD & NECK SURGICAL ASSOC SC

Practice address

1000 Ravinia PL
Orland Park, IL 60462-3764

Phone

(708) 460-6663

Fax

(708) 460-6693

NPI assigned

Feb 15, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Joseph P Gavron, MD

Title

Owner

Phone

(708) 460-6663

Specialties & licenses 1

Addresses

Other names 1

• Joseph P Gavron MD Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Thayer Lyon, M.D.

  • Otolaryngology Physician
  • Oak Lawn, IL
  • NPI 1467444661

  Otolaryngology

  NPD (past)

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336953600000",
    "number": "1104094804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 RAVINIA PL",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623764",
            "telephone_number": "708-460-6663",
            "fax_number": "708-460-6693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 RAVINIA PL",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623764",
            "telephone_number": "708-460-6663",
            "fax_number": "708-460-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST HEAD & NECK SURGICAL ASSOC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2012-05-14",
        "status": "A",
        "authorized_official_last_name": "GAVRON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-460-6663",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036054754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joseph P Gavron MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Southwest Endodontics
• Southwest Foot and Ankle, LLC
• Southwest Nephrology Associates, S.C.
• Southwest Psychiatric Services, SC
• Southwest Surgical Assistants
• Southwest Vision Therapy, P.C.
• Madison Spaargaren

• All providers in Orland Park, IL
• Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; 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.