Organization Active NPI

Associates in Head & Neck Surgery

  • Otolaryngology Physician
  • Chicago, IL
National Provider Identifier
1780674515
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
ASSOCIATES IN HEAD & NECK SURGERY
Practice address
1725 W Harrison St
Suite 938
Chicago, IL 60612-3841
Phone
(312) 942-2175
Fax
(312) 942-2052
NPI assigned
Oct 24, 2005
Last updated
Nov 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Authorized official

Name
Thomas J Nielsen, M.D.NPI 1235138546
Title
President
Phone
(312) 942-2175

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X NU

Addresses

Primary practice location

1725 W Harrison St
Suite 938
Chicago, IL 60612-3841

Mailing address

PO Box 9
Matteson, IL 60443-0009
Phone (708) 747-5850

Other identifiers 1

IdentifierTypeStateIssuer
CB1567OtherILRRMC

National Provider Directory

National Provider Directory

Locations

345 E Burlington St
Ste C2
Riverside, IL 60546
Phone (708) 442-1616

3722S Harlem Ave
Ste 205
Riverside, IL 60546

Practitioners & affiliated clinicians

Practitioners 3

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": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1780674515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604430009",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "address_2": "SUITE 938",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-942-2175",
            "fax_number": "312-942-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN HEAD & NECK SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-942-2175",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "CB1567",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.