Grand Avenue Surgical Center, LTD.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

7003133 Issued in IL

Legal business name

GRAND AVENUE SURGICAL CENTER, LTD.

Doing business as

Surgicare of Chicago

Practice address

17 W Grand Ave
Chicago, IL 60610-4306

Phone

(312) 222-5610

Fax

(312) 661-1771

NPI assigned

Jun 30, 2008

Organization subpart

Yes

Parent organization

J N R ASSOCIATES, INC.As reported in NPPES

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

Authorized official

Name

Mr. Javad Nercy Jafari, M.B.A.

Title

Administrator & Coo

Phone

(312) 222-5610

Specialties & licenses 1

Addresses

Other names 1

• Surgicare of Chicago Doing business as

Part of

JNR Associates Inc

Locations

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564963200000",
    "number": "1144482290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 W GRAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606104306",
            "telephone_number": "312-222-5610",
            "fax_number": "312-661-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W GRAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606104306",
            "telephone_number": "312-222-5610",
            "fax_number": "312-661-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND AVENUE SURGICAL CENTER, LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "J N R ASSOCIATES, INC.",
        "enumeration_date": "2008-06-30",
        "last_updated": "2019-08-05",
        "status": "A",
        "authorized_official_last_name": "JAFARI",
        "authorized_official_first_name": "JAVAD",
        "authorized_official_middle_name": "NERCY",
        "authorized_official_title_or_position": "ADMINISTRATOR & COO",
        "authorized_official_telephone_number": "312-222-5610",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.B.A."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7003133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgicare of Chicago",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Valerie Granados, L.C.S.W.
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• Katherine Granberry, M.D.
• Kristen Michelle Granchalek, LCSW
• Andrea Marie Grancher, PA-C
• Grand Dentistry
• Grand Dentistry Loop, LLC
• Grand Gonaives (Prime Wellness Homecare Services)
• Grand Home Health Care, Inc.
• Grand Medical Clinic, Inc

• Ambulatory Surgical Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.