Southwest Aesthetics and Body Sculpture, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

1371 Issued in IL

Legal business name

SOUTHWEST AESTHETICS AND BODY SCULPTURE, LLC

Practice address

217 Vertin Blvd
Shorewood, IL 60404-8783

Phone

(815) 545-9772

NPI assigned

Mar 13, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Eugene Chiu, MD

Title

Manager Member

Phone

(815) 545-9772

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

Practitioners 5

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

• Brian J Egan, DO

  • Obstetrics & Gynecology Physician
  • Joliet, IL
  • NPI 1366439226
  NPD (past)
• Thomas A Heggen, MD

  • Internal Medicine Physician
  • Buffalo Grove, IL
  • NPI 1710974860
  NPD (past)
• Angela Intili, M.D.

  • Obstetrics & Gynecology Physician
  • Joliet, IL
  • NPI 1114080033
  NPD (past)
• James H Kim, MD

  • Obstetrics & Gynecology Physician
  • Carol Stream, IL
  • NPI 1275520132
  NPD (past)
• Govind Ramadurai, M.D.

  • Cardiovascular Disease Physician
  • Joliet, IL
  • NPI 1184673089
  NPD (past)

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297987200000",
    "number": "1609017011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11009",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985081009",
            "telephone_number": "360-352-2037",
            "fax_number": "360-352-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 VERTIN BLVD",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604048783",
            "telephone_number": "815-545-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST AESTHETICS AND BODY SCULPTURE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-13",
        "last_updated": "2011-02-18",
        "status": "A",
        "authorized_official_last_name": "CHIU",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "MANAGER MEMBER",
        "authorized_official_telephone_number": "815-545-9772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "1371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088162",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065985",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PALMETTO GBA",
            "identifier": "P00870505",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087434",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PALMETTO GBA",
            "identifier": "P00870409",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PALMETTO GBA",
            "identifier": "DQ7598",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036053917",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latashia Silas
• Pierra Skinner, RD, LDN
• Agnieszka Sobecka, DEVELOP THERAPIST
• William E Sobodas II, ATC
• Southern Will County Coop
• Daniel Spaccapaniccia, DC
• Irene Stolis, PHARMD
• Rebecca Stonitsch, P.T.
• Rochelle Lee Strong, OTR/L
• Sabita Suwal

• Specialist in Shorewood, IL
• Providers in Shorewood, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; 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.