NPIMap

Organization Active NPI

St Ignatius Surgical Services LLC

  • Ambulatory Surgical Clinic/Center
  • Flossmoor, IL
National Provider Identifier
1730482944
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
N/A Issued in IL
Legal business name
ST IGNATIUS SURGICAL SERVICES LLC
Practice address
19801 Governors Hwy Ste 160
Flossmoor, IL 60422-4363
Phone
(708) 957-0505
Fax
(708) 957-0506
NPI assigned
Dec 9, 2010
Last updated
Dec 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Authorized official

Name
John Kung, MDNPI 1760483390
Title
Manager
Phone
(708) 957-0505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

19801 Governors Hwy Ste 160
Flossmoor, IL 60422-4363

Mailing address

19801 Governors Hwy Ste 160
Flossmoor, IL 60422-4363
Phone (708) 957-0505

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1730482944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19801 GOVERNORS HWY STE 160",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604224363",
            "telephone_number": "708-957-0505",
            "fax_number": "708-957-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19801 GOVERNORS HWY STE 160",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604224363",
            "telephone_number": "708-957-0505",
            "fax_number": "708-957-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST IGNATIUS SURGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "KUNG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-957-0505",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flossmoor, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.