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

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.

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

Locations

Practitioners 1

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

• 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
• 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.