NPIMap

Organization Active NPI

Surgeons Group, S.C.

  • Surgery Physician
  • Lake Forest, IL
National Provider Identifier
1235109745
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
042-000369 Issued in IL
Legal business name
SURGEONS GROUP, S.C.
Practice address
800 N Westmoreland Rd
Suite 205
Lake Forest, IL 60045-1673
Phone
(847) 234-4310
Fax
(847) 234-4336
NPI assigned
Jan 25, 2006
Last updated
Aug 31, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Authorized official

Name
Mary Dale Houston, R.N.
Title
Office Manager
Phone
(847) 234-4310

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 042-000369 IL Primary
Colon & Rectal Surgery Physician 208C00000X 042-000369 IL

Addresses

Primary practice location

800 N Westmoreland Rd
Suite 205
Lake Forest, IL 60045-1673

Mailing address

800 N Westmoreland Rd
Suite 205
Lake Forest, IL 60045-1673
Phone (847) 234-4310

National Provider Directory

National Provider Directory

Locations

800 N Westmoreland Rd
Ste 205
Lake Forest, IL 60045
Phone (847) 234-4310

Practitioners & affiliated clinicians

Practitioners 5

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": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1235109745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 205",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451673",
            "telephone_number": "847-234-4310",
            "fax_number": "847-234-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 205",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451673",
            "telephone_number": "847-234-4310",
            "fax_number": "847-234-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGEONS GROUP, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "HOUSTON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-234-4310",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "042-000369",
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "042-000369",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.