Adva-Med Surgical Association Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ADVA-MED SURGICAL ASSOCIATION INC

Doing business as

NCDS Ambulatory Care Center

Practice address

4201 W 95TH St
Oak Lawn, IL 60453-2615

Phone

(708) 636-7870

Fax

(708) 636-0264

NPI assigned

Apr 9, 2007

Organization subpart

No

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

Authorized official

Name

Miss Magdalena Mietus

Title

Office Manager

Phone

(708) 636-8546

Specialties & licenses 1

Addresses

Other names 1

• NCDS Ambulatory Care Center Doing business as

Locations

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861515355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532615",
            "telephone_number": "708-636-7870",
            "fax_number": "708-636-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532615",
            "telephone_number": "708-636-7870",
            "fax_number": "708-636-0264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVA-MED SURGICAL ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIETUS",
        "authorized_official_first_name": "MAGDALENA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "708-636-8546",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NCDS Ambulatory Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.