TLC Medical Group, S.C.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

03106052 Issued in IL

Legal business name

TLC MEDICAL GROUP, S.C.

Practice address

40W222 la Fox Road
Suite J1
Saint Charles, IL 60175

Phone

(630) 513-9160

Fax

(630) 513-9617

NPI assigned

Dec 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan SongNPI 1851452775

Title

Managing Physician

Phone

(630) 513-9160

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• TLC Women's Health S.C. Doing business as

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16704/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Jonathan Y Song, M.D.

  • Obstetrics & Gynecology Physician
  • Geneva, IL
  • NPI 1851452775
  NPD Authorized official

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547424000000",
    "number": "1487836284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40W222 LA FOX ROAD",
            "address_2": "SUITE J1",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "60175",
            "telephone_number": "630-513-9160",
            "fax_number": "630-513-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40W222 LA FOX ROAD",
            "address_2": "SUITE J1",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "60175",
            "telephone_number": "630-513-9160",
            "fax_number": "630-513-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC MEDICAL GROUP, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2019-01-14",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "630-513-9160",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "03106052",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036104024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1851452775",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "4532123",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TLC Women's Health S.C.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TLC Women's Health S.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holly Lynne Timmreck, PT, DPT
• Timothy W. Sheehan,LTD.
• Logan Tinsley
• Steven Tirabasso, D.C.
• Sheila M Tito
• TLC Medical Group, S.C.
• TMJ and Sleep Therapy Centre of Chicago LLC
• TMS Ventures LLC
• Karissa Samara Tobey, MA, LCPC
• Paulette C. Toburen, PSY.D.

• Gynecology Physician in Saint Charles, IL
• Providers in Saint Charles, IL by specialty
• Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.