Surgiacl Assistingservices of Lake County

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

Legal business name

SURGIACL ASSISTINGSERVICES OF LAKE COUNTY

Practice address

2400 N Samson Way
Apt#2D
Waukegan, IL 60087-5079

Phone

(122) 439-9931

Fax

(224) 944-0084

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Kim Ladell LusterNPI 1396870051

Title

Surgical Assistant

Phone

(224) 399-9317

Specialties & licenses 1

Addresses

Practitioners 1

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

• Kim Ladell Luster

  • Surgical Technologist
  • Waukegan, IL
  • NPI 1396870051
  NPD (past) Authorized official

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740315332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N SAMSON WAY",
            "address_2": "APT#2D",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600875079",
            "telephone_number": "122-439-9931",
            "fax_number": "224-944-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N SAMSON WAY",
            "address_2": "APT#2D",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600875079",
            "telephone_number": "122-439-9931",
            "fax_number": "224-944-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGIACL ASSISTINGSERVICES OF LAKE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUSTER",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "LADELL",
        "authorized_official_title_or_position": "SURGICAL ASSISTANT",
        "authorized_official_telephone_number": "12243999317",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra Strong
• Eve Strzelecki
• Ashley Styx, LCSW
• Luma Sukkar, M.D.
• Superior Medical Solutions Inc.
• Survivors Circle
• Tina L Sutton, RN
• Tracy Swain
• Paige Swan
• Annette Marie Swank

• Surgical Technologist in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Surgical Technologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.