NPIMap

Organization Active NPI

Southwest Head & Neck Surgical Assoc SC

Doing business as Joseph P Gavron MD

  • Otolaryngology Physician
  • Orland Park, IL
National Provider Identifier
1104094804
Registry record updated May 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036054754 Issued in IL
Legal business name
SOUTHWEST HEAD & NECK SURGICAL ASSOC SC
Doing business as
Joseph P Gavron MD
Practice address
1000 Ravinia PL
Orland Park, IL 60462-3764
Phone
(708) 460-6663
Fax
(708) 460-6693
NPI assigned
Feb 15, 2008
Last updated
May 14, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2012

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

Authorized official

Name
Dr. Joseph P Gavron, MDNPI 1467572925
Title
Owner
Phone
(708) 460-6663

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 036054754 IL Primary

Addresses

Primary practice location

1000 Ravinia PL
Orland Park, IL 60462-3764

Mailing address

1000 Ravinia PL
Orland Park, IL 60462-3764
Phone (708) 460-6663

Other names 1

  • Joseph P Gavron MD Doing business as

National Provider Directory

National Provider Directory

Locations

1000 Ravinia Pl
Orland Park, IL 60462
Phone (708) 460-6663

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": "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"
        }
    ]
}

Other providers in Orland Park, IL

Sources for this page

  • 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.