Active NPI
Progressive Surgical Associates SC
- Surgery Physician
- New Lenox, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 036103521
- Legal business name
- PROGRESSIVE SURGICAL ASSOCIATES SC
- Practice address
- 1890 Silver Cross Blvd
Suite 410
New Lenox, IL 60451-9524 - Phone
- (815) 717-8730
- Fax
- (815) 717-8729
- NPI assigned
- Jul 9, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Reza Gamagami, MD
- Title
- Owner
- Phone
- (815) 717-8730
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 036103521 | IL | Primary |
Addresses
Primary practice location
1890 Silver Cross Blvd
Suite 410
New Lenox, IL 60451-9524
Mailing address
1890 Silver Cross Blvd
Suite 410
New Lenox, IL 60451-9524
Phone (815) 717-8730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
Dept 5932
Carol Stream, IL 60122
1300 Copperfield Ave
Ste 3060
Joliet, IL 60432
Phone (815) 724-0932
1890 Silver Cross Blvd
Ste 410
New Lenox, IL 60451
Phone (815) 717-8730
1890 Silver Cross Blvd
Ste 520
New Lenox, IL 60451
Phone (815) 320-3060
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DHDHAA
Practitioners & affiliated clinicians
Practitioners 13
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Chicago, IL
- NPI 1194973768
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247097600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1344470400000",
"number": "1154550226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1890 SILVER CROSS BLVD",
"address_2": "SUITE 410",
"city": "NEW LENOX",
"state": "IL",
"postal_code": "604519524",
"telephone_number": "815-717-8730",
"fax_number": "815-717-8729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1890 SILVER CROSS BLVD",
"address_2": "SUITE 410",
"city": "NEW LENOX",
"state": "IL",
"postal_code": "604519524",
"telephone_number": "815-717-8730",
"fax_number": "815-717-8729"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROGRESSIVE SURGICAL ASSOCIATES SC",
"organizational_subpart": "NO",
"enumeration_date": "2009-07-09",
"last_updated": "2012-08-09",
"status": "A",
"authorized_official_last_name": "GAMAGAMI",
"authorized_official_first_name": "REZA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "815-717-8730",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": "IL",
"license": "036103521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Lenox, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.