Cary Grove Medical Associates, S.C.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

CARY GROVE MEDICAL ASSOCIATES, S.C.

Practice address

7105 Virginia Rd Ste 7
Crystal Lake, IL 60014-7986

Phone

(815) 444-1913

Fax

(815) 444-1951

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sol Bicomong Daya, M.D.

Title

Medical Doctor

Phone

(815) 444-1913

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780715292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7105 N. VIRGINIA ROAD",
            "address_2": "UNIT 7",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147986",
            "telephone_number": "815-444-1913",
            "fax_number": "815-444-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7105 VIRGINIA RD STE 7",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147986",
            "telephone_number": "815-444-1913",
            "fax_number": "815-444-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARY GROVE MEDICAL ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAYA",
        "authorized_official_first_name": "SOL",
        "authorized_official_middle_name": "BICOMONG",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "815-444-1913",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol a. Kotzan, M.D., S. C.
• Carol Kotzan MD LLC
• Zulema Carrillo Gonzalez, COTA/L
• Diana Lynn Carter, LCPC
• Holly Caruso, LPC
• Nicole Marie Cassidy
• Natalie Diana Castaneda
• Christian Diore Ronquillo Castillo
• Debra Jo Caulk
• Lauren Marie Cazanigo Browning

• Preferred Provider Organization in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Preferred Provider Organization 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.