Anti Aging Surgical Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

60011238 Issued in IL

Legal business name

ANTI AGING SURGICAL CENTER

Practice address

3918 W 63Rd St
Chicago, IL 60629-4604

Phone

(773) 284-9660

NPI assigned

Jun 5, 2009

Organization subpart

No

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

Authorized official

Name

Shanin Moshiri

Title

Medical Director/Own

Phone

(773) 284-9660

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1245466192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11232",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "773-284-9660",
            "fax_number": "773-284-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3918 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294604",
            "telephone_number": "773-284-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTI AGING SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-05",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "MOSHIRI",
        "authorized_official_first_name": "SHANIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWN",
        "authorized_official_telephone_number": "773-284-9660"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "60011238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larita M Anthony, MASTERS
• Robert Anthony, PA
• Shruti Elizabeth Anthony
• Sonja Anthony
• Tiffany Allyson Anthony, MD
• Tatjana Antic, M.D.
• Antillas South Medical Center, Inc
• Lina Antiporta, LCSW
• Jeanne Elizabeth Antisdel, PH.D.
• Kaci Lillian Antkiewicz

• Ambulatory Surgical Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.