NPIMap

Organization Active NPI

Advocate Southwest Ambulatory Surgery Center LLC

Doing business as Tinley Woods Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Tinley Park, IL
National Provider Identifier
1316009194
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
7002652 Issued in IL
Legal business name
ADVOCATE SOUTHWEST AMBULATORY SURGERY CENTER LLC
Doing business as
Tinley Woods Surgery Center
Practice address
18200 S. Lagrange Rd
Tinley Park, IL 60487
Phone
(708) 570-2490
Fax
(708) 570-2499
NPI assigned
Dec 15, 2006
Last updated
Jan 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Authorized official

Name
Mr. Ronald P Ladniak
Title
Administrator
Phone
(630) 852-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 7002652 IL Primary

Addresses

Primary practice location

18200 S. Lagrange Rd
Tinley Park, IL 60487

Mailing address

18200 S. Lagrange Rd
Tinley Park, IL 60487
Phone (708) 570-2490

Other identifiers 1

IdentifierTypeStateIssuer
490005727OtherILMEDICARE RAILROAD PROV #

Other names 1

  • Tinley Woods Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100125000020 IL Part B Supplier - Ambulatory Surgical Center 1759302227 Practice locations: Tinley Park, IL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Tinley Woods Surgery CenterCCN 14C0001097
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1008039Tinley Woods Surgery Center18200 S Lagrange Rd, Tinley Park, IL 60487Certificate of waiverJan 8, 2027

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264377600000",
    "number": "1316009194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18200 S. LAGRANGE RD",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "60487",
            "telephone_number": "708-570-2490",
            "fax_number": "708-570-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18200 S. LAGRANGE RD",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "60487",
            "telephone_number": "708-570-2490",
            "fax_number": "708-570-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATE SOUTHWEST AMBULATORY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2010-01-25",
        "status": "A",
        "authorized_official_last_name": "LADNIAK",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "630-852-9300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7002652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PROV #",
            "identifier": "490005727",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tinley Woods Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; 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.