Southwestern Medical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

7002264 Issued in IL

Legal business name

SOUTHWESTERN MEDICAL CENTER, LLC

Doing business as

Magna Surgical Center

Practice address

7456 S State Rd, Ste 300
Third Floor
Bedford Park, IL 60638-6621

Phone

(773) 445-9696

Fax

(773) 445-9590

NPI assigned

Jul 11, 2006

Last updated

Feb 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenny Bozorgi, MDNPI 1255568333

Title

Ceo

Phone

(773) 445-9696

Specialties & licenses 2

Addresses

Other names 1

• Magna Surgical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Southwestern Medical Center LLCCCN 14C0001025

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 11

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.

• Kenny Bozorgi, M.D.

  • Gynecologic Oncology Physician
  • Chicago, IL
  • NPI 1255568333
  NPD Authorized official
• Craig E Buckley, M.D.

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1366522120
  NPD (past)
• Donald L Carter, M.D.

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1700966546
  NPD (past)
• Adoracion L Duque, M.D.

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1083794945
  NPD (past)
• Jerome J Hannigan, M.D.

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1306926027
  NPD (past)
• Helene Pardo-Isaac, M.D.

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1093895849
  NPD (past)
• Krishnaswami Rangachari, M.D.

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1851471684
  NPD (past)
• Robert A Shrifter, M.D.

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1659451524
  NPD (past)
• John David Sonnenberg, MD

  • Orthopaedic Surgery Physician
  • Chicago, IL
  • NPI 1609829050
  NPD (past)
• Jay F Kiokemeister, D.O.

  • Anesthesiology Physician
  • Venice, FL
  • NPI 1629158472
  NPD (past)
• Valerie K Pasche, M.D.

  • Anesthesiology Physician
  • Winston Salem, NC
  • NPI 1184719114
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1790710390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88724",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601888724",
            "telephone_number": "773-445-9696",
            "fax_number": "773-445-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7456 S STATE RD, STE 300",
            "address_2": "THIRD FLOOR",
            "city": "BEDFORD PARK",
            "state": "IL",
            "postal_code": "606386621",
            "telephone_number": "773-445-9696",
            "fax_number": "773-445-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "BOZORGI",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-445-9696",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7002264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magna Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magna Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sangeeta Rameshchandra Patel, P.T
• Physiotherapy Associates Inc (Novacare Rehabilitation)
• Edward Joseph Pillar, D.O.
• Raj K Goyal MD SC
• Robert Gehrke OD
• Ben Sutti, PHARM.D.
• Reeham Tineh, OD
• Village of Bedford Park
• Wal-Mart Stores, Inc (Vision Center 30-1938)
• Walmart Inc.

• Ambulatory Surgical Clinic/Center in Bedford Park, IL
• Providers in Bedford Park, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.