Nasser Tavakoly, RCSA

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

Practice address

101 Royce Rd.
Suite 5
Bolingbrook, IL 60440

Phone

(630) 759-9070

Fax

(630) 759-9067

NPI assigned

Apr 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Delijan Surgical Assistants, Inc.

  • Surgical Technologist
  • Bolingbrook, IL
  • NPI 1497971709
  NPD (past) Authorized official

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205052529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.BOX 9274",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605679274",
            "telephone_number": "630-759-9070",
            "fax_number": "630-759-9067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ROYCE RD.",
            "address_2": "SUITE 5",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "60440",
            "telephone_number": "630-759-9070",
            "fax_number": "630-759-9067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAKOLY",
        "first_name": "NASSER",
        "name_prefix": "Mr.",
        "credential": "RCSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keerthi Tamragouri, M.D.
• Elizabeth Ann Tamulewicz, DT
• Michele L Tantillo, LCSW
• Ashley Marie Tapley
• Christina Targia, DC
• Elizabeth Joann Taylor, LCPC, CADC
• Holly Thalheimer, PHARMD
• Antony R Tharian, M.D.
• The Centre, LLC
• The Mahogany Berry LLC (TMB Transport)

• Surgical Technologist in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Surgical Technologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.