American Surgeons Group Inc

Organization Active NPI Foot & Ankle Surgery Podiatrist · Homewood, IL

NPI 1376567958 · NPPES record last updated Jun 29, 2015

Key facts

NPI
1376567958
Entity type
Organization (NPI type 2)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
Legal business name
AMERICAN SURGEONS GROUP INC
Practice address
1757 Ridge Rd
Homewood, IL 60430-1812
Phone
(708) 799-7500
Fax
(708) 798-4563
NPI assigned
Jul 27, 2006
Organization subpart
No

Authorized official

Name
Julia Eve Shauger, DPM NPI 1083628101
Title
President
Phone
(708) 799-7500

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 7

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in IL, IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040727000172 IL Part B Supplier - Clinic/Group Practice 1052381332 Receives reassigned benefits from 2 practitioners
Practice locations: Homewood, IL; Mokena, IL; South Chicago Heights, IL
O20071003000106 IN Part B Supplier - Clinic/Group Practice 1052381332 Receives reassigned benefits from 1 practitioner
Practice locations: Merrillville, IN
O20100930073006 IL DME Supplier - Physician - Podiatry 1052381332 Practice locations: Homewood, IL

National Provider Directory

Locations

3224 W 95th St
Evergreen Pk, IL 60805
Phone (708) 422-6300

655 N Lagrange Rd
Ste 205
Frankfort, IL 60423
Phone (815) 464-6885

1757 Ridge Rd
Ste 101
Homewood, IL 60430

19638 S La Grange Rd
Mokena, IL 60448
Phone (815) 464-6885

3042 Chicago Rd
South Chicago Heights, IL 60411
Phone (708) 755-7505

110 Ridge Rd
#14
Munster, IN 46321
Phone (219) 513-0100

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP
213ES0103X Yes

Addresses

Primary practice location

1757 Ridge Rd
Homewood, IL 60430-1812

Mailing address

1757 Ridge Rd
Homewood, IL 60430-1812
Phone (708) 799-7500

Other identifiers

IdentifierTypeStateIssuer
CK4095OtherILRAILROAD MEDICARE
01632534OtherILBCBS

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 29, 2015.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1376567958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1757 RIDGE RD",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301812",
            "telephone_number": "708-799-7500",
            "fax_number": "815-215-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 RIDGE RD",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301812",
            "telephone_number": "708-799-7500",
            "fax_number": "708-798-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN SURGEONS GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "SHAUGER",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "EVE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-799-7500",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK4095",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01632534",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

All providers in Homewood, IL · Foot & Ankle Surgery Podiatrist in Illinois

Sources for this page

Verify at the official NPI Registry.