ENT Surgical Consultants, LTD
Organization Active NPI Otolaryngology Physician · Joliet, IL
NPI 1881620177 · NPPES record last updated Oct 22, 2007
Key facts
- NPI
- 1881620177
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- Legal business name
- ENT SURGICAL CONSULTANTS, LTD
- Practice address
- 2201 Glenwood Ave
Joliet, IL 60435-5574 - Phone
- (815) 725-1191
- Fax
- (815) 725-2048
- NPI assigned
- Jun 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Thomas K Kron, MD
- Title
- President
- Phone
- (815) 725-1191
Practitioners 22
-
Kati Ann Casey, M.S.
-
Sung J Chung, MD
-
Amanda Diederich, AUDIOLOGIST
-
Scott W Divenere, MD
-
Kristine Eubanks, M.A. CCC-A
-
Stacy Lambin, M.A. CCC-A
-
Rajeev H Mehta, MD
-
Ankit M Patel, MD
-
Jennifer Lynne Sangston, MSCCCA
-
Lisa Marie Weberski I, M.S.
-
Elizabeth Wojtowicz, PA-C
-
Matthew Bartindale, M.D.
-
Alexandra White, AUD
-
Amanda Mae St Louis, FNP-C
-
Jamie Ellen Sikora, AU.D
-
Brenene Marie Brady, M.S. CCC-A
-
Dana Lee Fink, M.A., CCC-A
-
Sherwin Ritz, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040825000546 | IL | Part B Supplier - Clinic/Group Practice | 2668446584 |
Receives reassigned benefits from 18 practitioners Practice locations: Joliet, IL; Morris, IL; New Lenox, IL |
National Provider Directory
Locations
960 W US Route 6
Morris, IL 60450
1890 Silver Cross Blvd
Ste 435
New Lenox, IL 60451
Phone (815) 725-1191
15300 West Ave
Ste 305
Orland Park, IL 60462
Phone (708) 349-5500
Interoperability endpoints
- michaelgartlan@entsc.allscriptsdirect.net
- sungchung@entsc.allscriptsdirect.net
- scottdivenere@entsc.allscriptsdirect.net
- matthewbartindale@entsc.allscriptsdirect.net
- jeffreyweishaar@entsc.allscriptsdirect.net
- ankitpatel@entsc.allscriptsdirect.net
- rajeevmehta@entsc.allscriptsdirect.net
- walterrooney@entsc.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician |
207Y00000X | Yes |
Addresses
Primary practice location
2201 Glenwood Ave
Joliet, IL 60435-5574
Mailing address
2201 Glenwood Ave
Joliet, IL 60435-5574
Phone (815) 725-1191
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CH4890 | Other | IL | RR MEDICARE PROV # |
Other providers in Joliet, IL
- Endo-Med Clinic SC
- Danielle Engel
- David A Ensign
- ENT Surgical Associates
- ENT Surgical Consultants
- Stephen Scott Epner
- Eric Erickson
- Katie Erickson
- Ernesto Tan, M.D.S.C.
- Shaun Matthew Ernst
All providers in Joliet, IL · Otolaryngology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.