Winchester Endoscopy Center

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

WINCHESTER ENDOSCOPY CENTER

Practice address

1880 W Winchester Rd
Suite 201
Libertyville, IL 60048-5341

Phone

(847) 247-0187

Fax

(847) 247-0487

NPI assigned

Feb 2, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Ben Michael Stickan, MBA

Title

Office Administrator

Phone

(847) 247-0187

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1336287168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 W WINCHESTER RD",
            "address_2": "SUITE 201",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485341",
            "telephone_number": "847-247-0187",
            "fax_number": "847-247-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 W WINCHESTER RD",
            "address_2": "SUITE 201",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485341",
            "telephone_number": "847-247-0187",
            "fax_number": "847-247-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINCHESTER ENDOSCOPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-09-10",
        "status": "A",
        "authorized_official_last_name": "STICKAN",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "847-247-0187",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Williams, LCSW
• Willow Oak Pediatrics
• Kristin Wilson, SLP
• Winchester Aesthetic Surgical Suite, SC
• Winchester Ambulatory Surgery Center LLC
• Winchester Endoscopy, LLC
• Winchester Medical Group, S.C.
• Windy City Medical Specialists, LLC
• Peggy Wingo, PH.D.,LLC
• Emily Rose Winkler

• Gastroenterology Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.