Hispanic American Endoscopy Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

7003126 Issued in IL

Legal business name

HISPANIC AMERICAN ENDOSCOPY CENTER, LLC

Doing business as

Chicago Surgery Center, LLC

Practice address

3536 W Fullerton Ave
Chicago, IL 60647-2443

Phone

(773) 772-1212

Fax

(773) 697-8305

NPI assigned

Aug 16, 2007

Last updated

Apr 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Rosenthal, DCNPI 1922014992

Title

Owner

Phone

(312) 761-0100

Specialties & licenses 1

Addresses

Other names 1

• Chicago Surgery Center, LLC Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861684458. Details of each certification follow.

• CCN 14C0001136 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 14C0001136

Legal name

CHICAGO SURGERY CENTER, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Oct 4, 2008

Last certification

Aug 31, 2021

Ownership / control type

Proprietary

Facility address

3536 W Fullerton Avenue
Chicago, IL 60647

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

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Matthew Rosenthal, D.C.

  • Chiropractor
  • Chicago, IL
  • NPI 1922014992
  NPD Authorized official
• Ramon Andres Garcia Jr., M.D

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1235295999
  NPD (past)

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1861684458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472443",
            "telephone_number": "312-761-0100",
            "fax_number": "773-697-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472443",
            "telephone_number": "773-772-1212",
            "fax_number": "773-697-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HISPANIC AMERICAN ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "ROSENTHAL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-761-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7003126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chicago Surgery Center, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeremy Brook Hisaw, LCSW
• Taylor Hisek, RD
• Steven Webb Hish-Frisbie, SLP
• Lynette J. Hish, M.A.
• Megan Hiskey, APN
• Hispanic Health Foundation, Inc (Hispanic Kids Clinic)
• Hispanic Medical Services, S.C.
• Hispanic Regional Clinics SC
• Hispanic Therapeutic Center
• Hispanic Therapeutic Services Corp

• Ambulatory Surgical Clinic/Center in Chicago, IL
• Providers in Chicago, 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 Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.