Active NPI
Ko Surgical Associates P.C
- Surgery Physician
- Lombard, IL
National Provider Identifier
1225137359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- KO SURGICAL ASSOCIATES P.C
- Practice address
- 130 S Main St Ste 306
Lombard, IL 60148-2670 - Phone
- (630) 620-6040
- Fax
- (630) 620-6143
- NPI assigned
- Sep 22, 2006
- 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
- Sung-Tao Ko, M.D.
- Title
- President/Owner
- Phone
- (630) 833-0386
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | Primary |
Addresses
Primary practice location
130 S Main St Ste 306
Lombard, IL 60148-2670
Mailing address
130 S Main St Ste 306
Lombard, IL 60148-2670
Phone (630) 620-6040
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036-045253 | Medicaid | IL | |
| 0002215295 | Other | IL | BLUE CROSS |
National Provider Directory
National Provider DirectoryLocations
386 N York St
Ste 201
Elmhurst, IL 60126
Phone (630) 620-6040
130 S Main St
Ste 306
Lombard, IL 60148
Phone (630) 620-6040
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1452038400000",
"number": "1225137359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 S MAIN ST STE 306",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601482670",
"telephone_number": "630-620-6040",
"fax_number": "630-620-6143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 S MAIN ST STE 306",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601482670",
"telephone_number": "630-620-6040",
"fax_number": "630-620-6143"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KO SURGICAL ASSOCIATES P.C",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-22",
"last_updated": "2016-01-06",
"status": "A",
"authorized_official_last_name": "KO",
"authorized_official_first_name": "SUNG-TAO",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "630-833-0386",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036-045253",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "0002215295",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lombard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.