NPIMap

Organization Active NPI

American Healthcare Systems Illinois LLC

Doing business as Edwardsville Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Glen Carbon, IL
National Provider Identifier
1457051096
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
AMERICAN HEALTHCARE SYSTEMS ILLINOIS LLC
Doing business as
Edwardsville Ambulatory Surgery Center
Practice address
12 Ginger Creek Pkwy
Glen Carbon, IL 62034-3502
Phone
(818) 666-0602
NPI assigned
Mar 2, 2023
Last updated
Mar 2, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
AMERICAN HEALTHCARE SYSTEMS ILLINOIS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Authorized official

Name
Jonathan Burket
Title
Corporate Compliance
Phone
(818) 666-0602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

12 Ginger Creek Pkwy
Glen Carbon, IL 62034-3502

Mailing address

12 Ginger Creek Pkwy
Glen Carbon, IL 62034-3502

Other names 1

  • Edwardsville Ambulatory Surgery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
American Healthcare Systems Illinois LLC3 organizations share this tax ID, including this one
Part of
American Healthcare Systems Illinois LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1457051096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 GINGER CREEK PKWY",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 GINGER CREEK PKWY",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343502",
            "telephone_number": "818-666-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN HEALTHCARE SYSTEMS ILLINOIS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN HEALTHCARE SYSTEMS ILLINOIS LLC",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "BURKET",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CORPORATE COMPLIANCE",
        "authorized_official_telephone_number": "818-666-0602"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edwardsville Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.