NPIMap

Organization Active NPI

Northwest Community Day Surgery Center Inc

  • Ambulatory Surgical Clinic/Center
  • Arlington Heights, IL
National Provider Identifier
1194782342
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
7001209 Issued in IL
Legal business name
NORTHWEST COMMUNITY DAY SURGERY CENTER INC
Practice address
675 W Kirchhoff Rd
Arlington Heights, IL 60005-2371
Phone
(847) 618-7009
Fax
(847) 618-7069
NPI assigned
Apr 28, 2006
Last updated
Jun 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Authorized official

Name
Mr. Michael B Zenn
Title
Executive Vice President
Phone
(847) 618-5017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 7001209 IL Primary

Addresses

Primary practice location

675 W Kirchhoff Rd
Arlington Heights, IL 60005-2371

Mailing address

3060 W Salt Creek LN
Suite 110
Arlington Heights, IL 60005-5026
Phone (847) 618-4604

Other identifiers 3

IdentifierTypeStateIssuer
0001671515OtherILBLUE SHIELD
544OtherILBLUE CROSS
6251175OtherILAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100208000230 IL Part B Supplier - Ambulatory Surgical Center 1153464532 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arlington Heights, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

675 W Kirchhoff Rd
Arlington Heights, IL 60005
Phone (847) 618-7009

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1194782342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 W SALT CREEK LN",
            "address_2": "SUITE 110",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600055026",
            "telephone_number": "847-618-4604",
            "fax_number": "847-618-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W KIRCHHOFF RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052371",
            "telephone_number": "847-618-7009",
            "fax_number": "847-618-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST COMMUNITY DAY SURGERY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "ZENN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "847-618-5017",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7001209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0001671515",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "544",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "6251175",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.