Active NPI
Northwest Advanced Surgical Associates, SC
- Surgery Physician
- Chicago, IL
National Provider Identifier
1831104652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01620367 | Other | IL | BCBS |
| CC3272 | Other | IL | RAILROAD MEDICARE |
| 14D0907680 | Other | IL | CLIA |
National Provider Directory
National Provider DirectoryLocations
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.