NPIMap

Organization Active NPI

Brown Boulevard Surgical Suites

  • Pain Clinic/Center
  • Bourbonnais, IL
National Provider Identifier
1235598954
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
BROWN BOULEVARD SURGICAL SUITES
Practice address
461 Brown Blvd
Suite a
Bourbonnais, IL 60914-2322
Phone
(815) 932-7242
Fax
(815) 932-7307
NPI assigned
Feb 23, 2016
Last updated
Feb 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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

Authorized official

Name
Dr. Donald RolandNPI 1821074600
Title
Owner/Physician
Phone
(815) 932-7242

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

461 Brown Blvd
Suite a
Bourbonnais, IL 60914-2322

Mailing address

461 Brown Blvd
Suite a
Bourbonnais, IL 60914-2322

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1456185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1235598954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 BROWN BLVD",
            "address_2": "SUITE A",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 BROWN BLVD",
            "address_2": "SUITE A",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142322",
            "telephone_number": "815-932-7242",
            "fax_number": "815-932-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWN BOULEVARD SURGICAL SUITES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "ROLAND",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "815-932-7242",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.

Verify at the official NPI Registry.