South Loop Endoscopy and Wellness Center LLC

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

Legal business name

SOUTH LOOP ENDOSCOPY AND WELLNESS CENTER LLC

Practice address

2334 S Wabash Ave
Chicago, IL 60616-2112

Phone

(630) 889-9889

Fax

(630) 889-8977

NPI assigned

Feb 18, 2012

Last updated

Feb 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David C Chua, M.D.NPI 1346241585

Title

President

Phone

(630) 889-9889

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

South Loop Endoscopy and Wellness Center LLCCCN 14C0001156

Medicare certification status

ActiveFrom the Provider of Services file

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.

• David C Chua, MD

  • Gastroenterology Physician
  • Oakbrook Terrace, IL
  • NPI 1346241585
  Authorized official Same address or phone
• Jim ZB Lu, MD

  • Anatomic Pathology Physician
  • Buffalo Grove, IL
  • NPI 1073590337
  NPD (past)

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

{
    "created_epoch": "1329523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329523200000",
    "number": "1144593369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S280 SUMMIT AVE",
            "address_2": "COURT A",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813984",
            "telephone_number": "630-889-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2334 S WABASH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162112",
            "telephone_number": "630-889-9889",
            "fax_number": "630-889-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LOOP ENDOSCOPY AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-18",
        "last_updated": "2012-02-18",
        "status": "A",
        "authorized_official_last_name": "CHUA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-889-9889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Chicago Physicial Medicine
• South Chicago Sleep Lab, Inc.
• South Chicago SLF, LLC
• South Haven Behavioral Modification II Inc
• South Lake Medical Services, LTD
• South Loop Integrated Physicians LTD
• South Loop Living & Rehab Center LLC (Warren Barr South Loop)
• South Loop Massage LLC
• South Loop Pediatric Therapy LLC
• South Loop Pediatrics, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.