Illinois Phlebology Associates SC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

ILLINOIS PHLEBOLOGY ASSOCIATES SC

Practice address

14225 S 95TH Ave Ste 455
Orland Park, IL 60462-2266

Phone

(708) 873-3450

NPI assigned

May 27, 2006

Last updated

May 4, 2023By 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

Nathan Amoruso

Title

Sr VP Revenue

Phone

(847) 593-8460

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 26

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.

• Phillip Leon Cacioppo, M.D.

  • Specialist
  • Elk Grove Village, IL
  • NPI 1184759136
  Medicare reassignment NPD
• Di Fan, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Elk Grove Village, IL
  • NPI 1023245693
  Medicare reassignment NPD
• Margaret Galloway, NP

  • Nurse Practitioner
  • Elk Grove Village, IL
  • NPI 1881729754
  Medicare reassignment NPD
• Rakhi Khanna, D.O

  • Nephrology Physician
  • Gurnee, IL
  • NPI 1083689079
  Medicare reassignment NPD
• Charles Perrott, MD

  • Surgery Physician
  • Chicago, IL
  • NPI 1730112525
  Medicare reassignment NPD
• Kevin M Smith, MD

  • Family Medicine Physician
  • Burr Ridge, IL
  • NPI 1710096557
  Medicare reassignment NPD
• Dennis Dejesus, MD

  • Diagnostic Radiology Physician
  • Edina, MN
  • NPI 1629067327

  IL, Vascular & Interventional Radiology

  Medicare reassignment NPD
• Stuart M Feldman, D.O.

  • Emergency Medicine Physician
  • Milwaukee, WI
  • NPI 1760434633

  IL

  Medicare reassignment NPD
• Joseph E Graham, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Ogden, UT
  • NPI 1578638383

  IL

  Medicare reassignment NPD
• Umang Patel, M.D.

  • Family Medicine Physician
  • Mansfield, TX
  • NPI 1710305735

  IL, Phlebology

  Medicare reassignment NPD
• Benjamin B Tang, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Merrillville, IN
  • NPI 1225112196

  IL

  Medicare reassignment NPD
• Bryan O'Neil Potter, M.D.

  • Surgery Physician
  • Billings, MT
  • NPI 1316967045
  NPD

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1154378040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650451",
            "telephone_number": "847-593-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14225 S 95TH AVE STE 455",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622266",
            "telephone_number": "708-873-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS PHLEBOLOGY ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "AMORUSO",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "SR VP REVENUE",
        "authorized_official_telephone_number": "847-593-8460"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Umeadi Pamela Imanlihen-Iyare
• Infinite Behavioral Interventions LLC
• Ing-Ing Lam MD
• Carol M Ingrisano, NP

• Surgery Physician in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.