Organization Active NPI

Surgical Specialty Center, LTD.

  • Clinic/Center
  • Chicago, IL
National Provider Identifier
1417028879
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SURGICAL SPECIALTY CENTER, LTD.
Practice address
6043 W Belmont Ave
Chicago, IL 60634-5116
Phone
(773) 745-5400
Fax
(773) 745-1998
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Authorized official

Name
Dr. Jeffrey J. Betman, D.P.M.
Title
Medical Director
Phone
(773) 745-1919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

6043 W Belmont Ave
Chicago, IL 60634-5116

Mailing address

6043 W Belmont Ave
Chicago, IL 60634-5116
Phone (773) 745-5400

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
14D0962056Surgical Specialty Center LTD6043 W Belmont Ave, Chicago, IL 60634Certificate of waiverJun 22, 2027

National Provider Directory

National Provider Directory

Locations

6043 W Belmont Ave
Chicago, IL 60634
Phone (773) 745-5400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1417028879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6043 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606345116",
            "telephone_number": "773-745-5400",
            "fax_number": "773-745-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6043 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606345116",
            "telephone_number": "773-745-5400",
            "fax_number": "773-745-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SPECIALTY CENTER, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "BETMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "773-745-1919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.