Organization Active NPI

Northwest Advanced Surgical Associates, SC

  • Surgery Physician
  • Chicago, IL
National Provider Identifier
1831104652
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NORTHWEST ADVANCED SURGICAL ASSOCIATES, SC
Practice address
6374 N Lincoln Ave
Suite 301
Chicago, IL 60659-1275
Phone
(773) 478-5600
Fax
(773) 478-5602
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

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

Authorized official

Name
Spiros Giannoulias, MD
Title
Director
Phone
(773) 478-5600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

6374 N Lincoln Ave
Suite 301
Chicago, IL 60659-1275

Mailing address

6374 N Lincoln Ave
Suite 301
Chicago, IL 60659-1275
Phone (773) 478-5600

Other identifiers 3

IdentifierTypeStateIssuer
01620367OtherILBCBS
CC3272OtherILRAILROAD MEDICARE
14D0907680OtherILCLIA

National Provider Directory

National Provider Directory

Locations

6374 N Lincoln Ave
Ste 301
Chicago, IL 60659
Phone (630) 924-1450

Practitioners & affiliated clinicians

Practitioners 1

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": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296432000000",
    "number": "1831104652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6374 N LINCOLN AVE",
            "address_2": "SUITE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591275",
            "telephone_number": "773-478-5600",
            "fax_number": "773-478-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6374 N LINCOLN AVE",
            "address_2": "SUITE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591275",
            "telephone_number": "773-478-5600",
            "fax_number": "773-478-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST ADVANCED SURGICAL ASSOCIATES, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2011-01-31",
        "status": "A",
        "authorized_official_last_name": "GIANNOULIAS",
        "authorized_official_first_name": "SPIROS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-478-5600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01620367",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC3272",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "14D0907680",
            "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 Jan 31, 2011; 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.