Organization Active NPI

Round Lake Medical Suites

  • Endoscopy Clinic/Center
  • Round Lake Beach, IL
National Provider Identifier
1861513822
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
License
42618258 Issued in IL
Legal business name
ROUND LAKE MEDICAL SUITES
Practice address
2 E Rollins Rd
Suite 108
Round Lake Beach, IL 60073-3808
Phone
(847) 546-9455
Fax
(847) 247-2840
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Susan Goodman
Title
Office Manager
Phone
(847) 984-6452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X 42618258 IL Primary

Addresses

Primary practice location

2 E Rollins Rd
Suite 108
Round Lake Beach, IL 60073-3808

Mailing address

2 E Rollins Rd
Suite 108
Round Lake Beach, IL 60073-3808
Phone (847) 546-9455

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0414039Round Lake Medical2 E Rollins Rd, Round Lake, IL 60073Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861513822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E ROLLINS RD",
            "address_2": "SUITE 108",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600733808",
            "telephone_number": "847-546-9455",
            "fax_number": "847-247-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 E ROLLINS RD",
            "address_2": "SUITE 108",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600733808",
            "telephone_number": "847-546-9455",
            "fax_number": "847-247-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUND LAKE MEDICAL SUITES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-984-6452"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "IL",
            "license": "42618258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Lake Beach, IL

Sources for this page

  • 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.
  • 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.