Active NPI
Surgery Group SC
- Surgery Physician
- Geneva, IL
National Provider Identifier
1235213802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- SURGERY GROUP SC
- Practice address
- 1665 South St
Geneva, IL 60134-2542 - Phone
- (630) 208-7874
- Fax
- (630) 208-7880
- NPI assigned
- Oct 24, 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
- Jodi Krusely
- Title
- Account Manager
- Phone
- (847) 838-3832
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | Primary |
Addresses
Primary practice location
1665 South St
Geneva, IL 60134-2542
Mailing address
1665 South St
Geneva, IL 60134-2542
Phone (630) 208-7874
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1710 N Randall Rd
Ste 320
Elgin, IL 60123
Phone (847) 697-4700
87 N Airlite St
Ste 150
Elgin, IL 60123
Phone (847) 697-5141
1665 South St
Geneva, IL 60134
Phone (630) 208-7874
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Surgery Physician
- Geneva, IL
- NPI 1700881737
-
- Surgery Physician
- Geneva, IL
- NPI 1659440097
-
- Family Medicine Physician
- Sycamore, IL
- NPI 1184614760
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1352332800000",
"number": "1235213802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1665 SOUTH ST",
"city": "GENEVA",
"state": "IL",
"postal_code": "601342542",
"telephone_number": "630-208-7874",
"fax_number": "630-208-7880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1665 SOUTH ST",
"city": "GENEVA",
"state": "IL",
"postal_code": "601342542",
"telephone_number": "630-208-7874",
"fax_number": "630-208-7880"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SURGERY GROUP SC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-24",
"last_updated": "2012-11-08",
"status": "A",
"authorized_official_last_name": "KRUSELY",
"authorized_official_first_name": "JODI",
"authorized_official_title_or_position": "ACCOUNT MANAGER",
"authorized_official_telephone_number": "847-838-3832"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Geneva, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.