Suburban Urology Associates,LTD

Primary specialty

SpecialistTaxonomy code 174400000X

License

36061571 Issued in IL

Legal business name

SUBURBAN UROLOGY ASSOCIATES,LTD

Practice address

3340 Oak Park Ave
Suite 305
Berwyn, IL 60402-3420

Phone

(708) 484-6019

Fax

(708) 484-0251

NPI assigned

Dec 18, 2007

Organization subpart

Yes

Parent organization

SUBURBAN UROLOGY ASSOCIATES,LTDAs reported in NPPES

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

Authorized official

Name

Dr. Peter Misurec, M,D.

Title

President

Phone

(708) 484-6019

Specialties & licenses 1

Addresses

Part of

Suburban Urology Associates

Locations

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1366626996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 OAK PARK AVE",
            "address_2": "SUITE 305",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023420",
            "telephone_number": "708-484-6019",
            "fax_number": "708-484-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 OAK PARK AVE",
            "address_2": "SUITE 305",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023420",
            "telephone_number": "708-484-6019",
            "fax_number": "708-484-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN UROLOGY ASSOCIATES,LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUBURBAN UROLOGY ASSOCIATES,LTD",
        "enumeration_date": "2007-12-18",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "MISUREC",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-484-6019",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M,D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "36061571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leroy Stromberg III, MD
• Patrick Suberlak, M.D.
• Subodh C Desai MD SC
• Suburban Otolaryngology,S.C.
• Suburban Physical Therapy Inc
• Karen Suggs, LSW
• Andrea Jo Swanson, MS QMHP
• Michael Szewczyk, PHARMD
• Saatema Tashan Tabb
• Tabitha a Watts MD LTD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.