Organization Active NPI

Algonquin Road Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Lake in the Hills, IL
National Provider Identifier
1558344846
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ALGONQUIN ROAD SURGERY CENTER, LLC
Practice address
2550 W Algonquin Rd
Lake in the Hills, IL 60156-3503
Phone
(847) 458-1246
Fax
(847) 458-1509
NPI assigned
Nov 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Authorized official

Name
Judith Kazy-Garey, MA
Title
Executive Director
Phone
(847) 960-1044

Specialties & licenses 1

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

Addresses

Primary practice location

2550 W Algonquin Rd
Lake in the Hills, IL 60156-3503

Mailing address

2550 W Algonquin Rd
Lake in the Hills, IL 60156-3503
Phone (847) 458-1246

Other identifiers 1

IdentifierTypeStateIssuer
50195OtherILBLUE CROSS BLUE SHEILD IL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090216000201 IL Part B Supplier - Ambulatory Surgical Center 2961567573 Practice locations: Lake in the Hills, IL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Algonquin Road Surgery Center LLCCCN 14C0001096
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1001080Algonquin Road Surgery Center2550 Algonquin Road, Lake in the Hills, IL 60156Certificate of waiverJun 27, 2028

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748908800000",
    "number": "1558344846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 W ALGONQUIN RD",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601563503",
            "telephone_number": "847-458-1246",
            "fax_number": "847-458-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 W ALGONQUIN RD",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601563503",
            "telephone_number": "847-458-1246",
            "fax_number": "847-458-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALGONQUIN ROAD SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A",
        "authorized_official_last_name": "KAZY-GAREY",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "847-960-1044",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD IL",
            "identifier": "50195",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake in the Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.