Associated Surgical Group, SC

Primary specialty

SpecialistTaxonomy code 174400000X

License

042-000313 Issued in IL

Legal business name

ASSOCIATED SURGICAL GROUP, SC

Practice address

7303 N Knoxville Ave
Peoria, IL 61614-2017

Phone

(309) 691-4005

Fax

(309) 691-6144

NPI assigned

Aug 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gavish N Patel, M.D.

Title

President

Phone

(309) 691-4005

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1336255124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7303 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142017",
            "telephone_number": "309-691-4005",
            "fax_number": "309-691-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7303 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142017",
            "telephone_number": "309-691-4005",
            "fax_number": "309-691-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED SURGICAL GROUP, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "GAVISH",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-691-4005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "042-000313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adee Athiyaman, MD
• Angel D Atkins, CNM, WHNP, APN

• Specialist in Peoria, IL
• Providers in Peoria, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.