Century Ear Nose and Throat - Head and Neck Surgery Associates LTD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

CENTURY EAR NOSE AND THROAT - HEAD AND NECK SURGERY ASSOCIATES LTD

Practice address

16001 108TH Ave
Orland Park, IL 60467-8788

Phone

(708) 460-0007

Fax

(708) 460-0005

NPI assigned

Sep 15, 2006

Last updated

Sep 4, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brian P Farrell, M.D.NPI 1558320747

Title

Doctor

Phone

(708) 460-0008

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian Patrick Farrell, MD

  • Otolaryngology Physician
  • Orland Park, IL
  • NPI 1558320747
  Medicare reassignment NPD Authorized official
• Muhamad Amine, M.D.

  • Otolaryngology Physician
  • Champaign, IL
  • NPI 1487884854
  Medicare reassignment NPD
• Anna J Baldwin, MS CCC-SLP

  • Speech-Language Pathologist
  • Oak Lawn, IL
  • NPI 1508197914
  Medicare reassignment NPD
• Linda Brigit Bosack, AUD

  • Audiologist
  • Orland Park, IL
  • NPI 1265641955
  Medicare reassignment NPD
• David Chan

  • Otolaryngology Physician
  • Chicago, IL
  • NPI 1538480181
  Medicare reassignment NPD
• Krystyna Gal, D.O.

  • Facial Plastic Surgery Physician
  • Orland Park, IL
  • NPI 1588964357
  Medicare reassignment NPD
• Bernadette Gruchalski, NP-C

  • Family Nurse Practitioner
  • Flossmoor, IL
  • NPI 1760999783
  Medicare reassignment NPD
• Carley Khan, FNP-C

  • Family Nurse Practitioner
  • Orland Park, IL
  • NPI 1992526487
  Medicare reassignment NPD
• Philip Dean Kooiker, MD

  • Otolaryngology Physician
  • Orland Park, IL
  • NPI 1770552192
  Medicare reassignment NPD
• Susan Thayer Lyon, M.D.

  • Otolaryngology Physician
  • Oak Lawn, IL
  • NPI 1467444661
  Medicare reassignment NPD
• Silvio Marra, MD

  • Otolaryngology Physician
  • Orland Park, IL
  • NPI 1235198383
  Medicare reassignment NPD
• Joy Noelle Nestel, APRN

  • Nurse Practitioner
  • Orland Park, IL
  • NPI 1669169413
  Medicare reassignment NPD

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346716800000",
    "number": "1629174834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10660 W 143RD ST",
            "address_2": "SUITE B",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621989",
            "telephone_number": "708-460-4499",
            "fax_number": "708-460-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 108TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678788",
            "telephone_number": "708-460-0007",
            "fax_number": "708-460-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTURY EAR NOSE AND THROAT - HEAD AND NECK SURGERY ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2012-09-04",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "708-460-0008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01607201",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "CM5539",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Century Audiology (Linda Bosack M S)
• Dalia E Cepele, D.D.S.
• Rasa Cepukenaite
• Elizabeth Chabot, SLP
• Pragathi Challa, MD
• Joseph Chan, D.O.

• Otolaryngology Physician in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.