Organization Active NPI

Alliance Internal Medicine, S.C.

  • Internal Medicine Physician
  • Bourbonnais, IL
National Provider Identifier
1710120696
Registry record updated May 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036090542 Issued in IL
Legal business name
ALLIANCE INTERNAL MEDICINE, S.C.
Practice address
370 Larry Power Rd
Suite 2
Bourbonnais, IL 60914
Phone
(815) 523-2070
Fax
(815) 523-7022
NPI assigned
Apr 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2010

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

Authorized official

Name
Dr. Saw M Oo, M.D.NPI 1093813156
Title
President
Phone
(815) 523-2070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 036090440 IL
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 036108040 IL
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 036090542 IL Primary

Addresses

Primary practice location

370 Larry Power Rd
Suite 2
Bourbonnais, IL 60914

Mailing address

370 Larry Power Rd
Suite 2
Bourbonnais, IL 60914-5193
Phone (815) 523-7020

Other identifiers 3

IdentifierTypeStateIssuer
036108040OtherILSAW OO, M.D.
036090542OtherILJOEL VILLEGAS, M.D
036090440OtherILDR. CHANDAN D.O.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090819000671 IL Part B Supplier - Clinic/Group Practice 2668526047 Receives reassigned benefits from 2 practitioners
Practice locations: Bourbonnais, IL

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
14D1100853Alliance Internal Medicine S C370 Larry Power Road, Suite #2, Bourbonnais, IL 60914Certificate of waiverJun 14, 2027

National Provider Directory

National Provider Directory

Locations

370 Larry Power Rd
Bourbonnais, IL 60914
Phone (815) 523-7020

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1710120696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 LARRY POWER RD",
            "address_2": "SUITE 2",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145193",
            "telephone_number": "815-523-7020",
            "fax_number": "815-523-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 LARRY POWER RD",
            "address_2": "SUITE 2",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "60914",
            "telephone_number": "815-523-2070",
            "fax_number": "815-523-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE INTERNAL MEDICINE, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-08",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "OO",
        "authorized_official_first_name": "SAW",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-523-2070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036090440",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036108040",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036090542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAW OO, M.D.",
            "identifier": "036108040",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOEL VILLEGAS, M.D",
            "identifier": "036090542",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. CHANDAN D.O.",
            "identifier": "036090440",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; 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.