Surjit Thiara, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036073740 Issued in IL

Practice address

915 N Caron Rd
Rochelle, IL 61068-9649

Phone

(815) 562-4014

NPI assigned

Jan 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1609856715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 418",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "610680418",
            "telephone_number": "815-654-7772",
            "fax_number": "815-654-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N CARON RD",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "610689649",
            "telephone_number": "815-562-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIARA",
        "first_name": "SURJIT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036073740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036073740",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Swedishamerican Hospital
• Swedishamericanhospital Association
• Max Marco Tejeda-Nichols, C.D.
• Bradley Teo
• Diana Thiara, MD
• Belinda Colleen Thomas, FSW,MHP
• Brigitte Deanne Thornburg
• Sharon Elizabeth Bube Tilley, PH.D.
• Ian M Todd, MD
• Shannon Tompkins

• General Practice Physician in Rochelle, IL
• Providers in Rochelle, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.