NPIMap

Organization Active NPI

Logan Square Surgery Center Corp

  • Surgery Physician
  • Chicago, IL
National Provider Identifier
1457961518
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
LOGAN SQUARE SURGERY CENTER CORP
Doing business as
Logan Square Surgery Center Corp
Practice address
2006 N Pulaski Rd
Chicago, IL 60639
Phone
(773) 772-8876
NPI assigned
Aug 4, 2020
Last updated
Aug 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Authorized official

Name
Haifa SharifehNPI 1801405261
Title
Owner
Phone
(773) 772-8876

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

2006 N Pulaski Rd
Chicago, IL 60639

Mailing address

2006 N Pulaski Rd
Chicago, IL 60639
Phone (773) 772-8876

Other names 1

  • Logan Square Surgery Center Corp Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596499200000",
    "number": "1457961518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 N PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60639",
            "telephone_number": "773-772-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 N PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60639",
            "telephone_number": "773-772-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN SQUARE SURGERY CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A",
        "authorized_official_last_name": "SHARIFEH",
        "authorized_official_first_name": "HAIFA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-772-8876"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logan Square Surgery Center Corp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 4, 2020; 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.