Active NPI
Round Lake Medical Suites
- Endoscopy Clinic/Center
- Round Lake Beach, IL
National Provider Identifier
1861513822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endoscopy Clinic/Center
- License
- 42618258
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0414039 | Round Lake Medical | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1245238344
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.