Chicago Surgical Specialists, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

CHICAGO SURGICAL SPECIALISTS, LLC

Practice address

22 S Washington Ave
Park Ridge, IL 60068-4267

Phone

(847) 268-3910

Fax

(847) 897-3118

NPI assigned

Dec 3, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Anthony M. Spina, D.D.S., M.D.NPI 1508850272

Title

Owner

Phone

(847) 268-3910

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anthony M Spina, DDS MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Park Ridge, IL
  • NPI 1508850272
  Medicare reassignment Care Compare group NPD Authorized official
• Victor Cimino, MD, DDS

  • Plastic and Reconstructive Surgery Physician
  • Park Ridge, IL
  • NPI 1194792911

  Oral and Maxillofacial Surgery

  Medicare reassignment Care Compare group NPD
• Mariusz Kajetan Wrzosek, D.M.D., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Maywood, IL
  • NPI 1144274853
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1235560178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S WASHINGTON AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684267",
            "telephone_number": "847-268-3910",
            "fax_number": "847-897-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S WASHINGTON AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684267",
            "telephone_number": "847-268-3910",
            "fax_number": "847-897-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO SURGICAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-03",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "SPINA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-268-3910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.