Metro North Surgical Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

METRO NORTH SURGICAL CENTER

Practice address

2651 N Laramie Ave
Chicago, IL 60639-1613

Phone

(920) 217-6052

NPI assigned

Oct 15, 2020

Organization subpart

Yes

Parent organization

METRO NORTH SURGERY CENTERAs reported in NPPES

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

Authorized official

Name

Jamie L Vandenelzen, DC

Title

Owner

Phone

(920) 217-6052

Specialties & licenses 1

Addresses

Part of

Metro North Surgical Center

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1508464074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 N KNIGHT AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683108",
            "telephone_number": "920-217-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 N LARAMIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391613",
            "telephone_number": "920-217-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO NORTH SURGICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METRO NORTH SURGERY CENTER",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "VANDENELZEN",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-217-6052",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Metro Eye Care
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• Metro Portable X-Ray Service
• Metro Urgent Care Inc
• Metro Urgent Care Inc
• Metromed Laboratories, Inc.

• Ambulatory Surgical Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.