Surgical Associates of Bloomington, Ill,LTD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

SURGICAL ASSOCIATES OF BLOOMINGTON, ILL,LTD

Practice address

1404 Eastland Drive
Suite 104
Bloomington, IL 61701

Phone

(309) 663-4351

Fax

(309) 663-8359

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Lawrence A. Raines, MD

Title

President

Phone

(309) 663-4351

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1447355383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 EASTLAND DRIVE",
            "address_2": "SUITE 104",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61701",
            "telephone_number": "309-663-4351",
            "fax_number": "309-663-8359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 EASTLAND DRIVE",
            "address_2": "SUITE 104",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61701",
            "telephone_number": "309-663-4351",
            "fax_number": "309-663-8359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES OF BLOOMINGTON, ILL,LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "RAINES",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-663-4351",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica M Sullivan, CNP
• Ken James Summers, MS, LMFT
• Summit Family Medical Center
• Superior Anesthesia Solutions, LLC
• Supported Residential
• Adriann Sutton
• Ashley Sutton, BS, CADC
• Trevor Alan Suyak, APRN, FNP
• Kathryn A Swain-Abraham, APN
• Rajagopala Swaminathan, MD

• Surgery Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; 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.