NPIMap

Organization Active NPI

Highland Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Highland, IL
National Provider Identifier
1790739894
Registry record updated Jun 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
7002868 Issued in IL
Legal business name
HIGHLAND AMBULATORY SURGICAL CENTER, LLC
Practice address
1212 Broadway
Suite C
Highland, IL 62249-1960
Phone
(618) 654-8100
Fax
(618) 654-4563
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2010

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

Authorized official

Name
Keith R Thomae, M.D.NPI 1184679409
Title
President
Phone
(618) 654-8100

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 7002868 IL Primary

Addresses

Primary practice location

1212 Broadway
Suite C
Highland, IL 62249-1960

Mailing address

1212 Broadway
Suite C
Highland, IL 62249-1960
Phone (618) 654-8100

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275350400000",
    "number": "1790739894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 BROADWAY",
            "address_2": "SUITE C",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491960",
            "telephone_number": "618-654-8100",
            "fax_number": "618-654-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 BROADWAY",
            "address_2": "SUITE C",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491960",
            "telephone_number": "618-654-8100",
            "fax_number": "618-654-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND AMBULATORY SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2010-06-01",
        "status": "A",
        "authorized_official_last_name": "THOMAE",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-654-8100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7002868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.