NPIMap

Organization Active NPI

Complete Care Medical Center, S.C

  • Adolescent Medicine (Family Medicine) Physician
  • Elgin, IL
National Provider Identifier
1144517830
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
License
036085859 Issued in IL
Legal business name
COMPLETE CARE MEDICAL CENTER, S.C
Practice address
373 Summit St Ste 100
Elgin, IL 60120
Phone
(847) 888-3631
Fax
(847) 888-3632
NPI assigned
Jul 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Authorized official

Name
Dr. Orawan Sukavachana, M.D.NPI 1841332442
Title
President/Ceo
Phone
(847) 650-1452

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0000X 036085859 IL Primary

Addresses

Primary practice location

373 Summit St Ste 100
Elgin, IL 60120

Mailing address

373 Summit St Ste 102
Elgin, IL 60012
Phone (847) 888-3631

National Provider Directory

National Provider Directory

Locations

373 Summit St
Ste 100
Elgin, IL 60120
Phone (847) 888-3631

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1144517830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 SUMMIT ST STE 102",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60012",
            "telephone_number": "847-888-3631",
            "fax_number": "847-888-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 SUMMIT ST STE 100",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60120",
            "telephone_number": "847-888-3631",
            "fax_number": "847-888-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE MEDICAL CENTER, S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "SUKAVACHANA",
        "authorized_official_first_name": "ORAWAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "847-650-1452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "IL",
            "license": "036085859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.