NPIMap

Organization Active NPI

Surgical Specialty Partners, LTD.

  • Specialist
  • Bolingbrook, IL
National Provider Identifier
1154379931
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SURGICAL SPECIALTY PARTNERS, LTD.
Practice address
580 E Boughton Rd
Suite B
Bolingbrook, IL 60440-2140
Phone
(630) 972-1599
Fax
(630) 972-1050
NPI assigned
May 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Allan J. Libunao, D.D.S.NPI 1760499222
Title
Owner/Partner
Phone
(630) 972-1599

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X IL Primary

Addresses

Primary practice location

580 E Boughton Rd
Suite B
Bolingbrook, IL 60440-2140

Mailing address

580 E Boughton Rd
Suite B
Bolingbrook, IL 60440-2140
Phone (630) 972-1599

Other names 1

  • Suburban Oral Surgery and Implant Center Doing business as

National Provider Directory

National Provider Directory

Locations

580 E Boughton Rd
Ste B
Bolingbrook, IL 60440
Phone (630) 972-1599

Practitioners & affiliated clinicians

Practitioners 2

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": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154379931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 E BOUGHTON RD",
            "address_2": "SUITE B",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402140",
            "telephone_number": "630-972-1599",
            "fax_number": "630-972-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 E BOUGHTON RD",
            "address_2": "SUITE B",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402140",
            "telephone_number": "630-972-1599",
            "fax_number": "630-972-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SPECIALTY PARTNERS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIBUNAO",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "630-972-1599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suburban Oral Surgery and Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.