Westmont Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

7002587 Issued in IL

Legal business name

WESTMONT SURGERY CENTER LLC

Practice address

530 N Cass Ave
Westmont, IL 60559-1503

Phone

(630) 869-4212

Fax

(630) 794-8662

NPI assigned

Dec 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Marc Fajardo, M.D.

Title

Administrator

Phone

(630) 794-8671

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Salt Creek Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Salt Creek Surgery CenterCCN 14C0001093

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Edward Health Ventures

  • Neurological Surgery Physician
  • Naperville, IL
  • NPI 1396976445

  Member Of

  NPD member
• Hinsdale Orthopaedic Associates,SC

  • Specialist
  • Oak Park, IL
  • NPI 1467750448

  Member Of

  NPD member

Practitioners 1

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

• Kenneth L Schiffman, M.D.

  • Orthopaedic Hand Surgery Physician
  • Galena, IL
  • NPI 1760574214
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1295897106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N CASS AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591503",
            "telephone_number": "630-869-4212",
            "fax_number": "630-794-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N CASS AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591503",
            "telephone_number": "630-869-4212",
            "fax_number": "630-794-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTMONT SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "FAJARDO",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "630-794-8671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7002587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490005583",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salt Creek Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Westmont Manor HRC LLC
• Westmont Nursing and Rehabilitation Center LLC
• Westmont Physical Therapy
• Westmont Physical Therapy and Rehab Inc
• Westmont Smiles Dental PLLC
• Chung Jue Wey Wu, MD
• White Dove Healthcare PLLC
• Luke Whittenberger
• Benjamin Wiley
• April Marie Wilkins

• All providers in Westmont, IL
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.