Midwest Surgical Associates, S.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

036-053291 Issued in IL

Legal business name

MIDWEST SURGICAL ASSOCIATES, S.C.

Practice address

5201 Willow Springs Rd
Suite 180
La Grange Highlands, IL 60525-6537

Phone

(708) 579-9705

Fax

(708) 579-0346

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Colleen Ann Hagen, M.D.

Title

President

Phone

(708) 579-9705

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375056000000",
    "number": "1881729879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD",
            "address_2": "SUITE 180",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605256537",
            "telephone_number": "708-579-9705",
            "fax_number": "708-579-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD",
            "address_2": "SUITE 180",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605256537",
            "telephone_number": "708-579-9705",
            "fax_number": "708-579-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST SURGICAL ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2013-07-29",
        "status": "A",
        "authorized_official_last_name": "HAGEN",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-579-9705",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-053291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273425786603013",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "31600057",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veronica Matticks, APN
• Stacy L McClure, MD
• Heidi Sue McLaughlin, M.D.
• Vinesh R Melvani
• Jill Rae Michalak, BC-HID
• Michael Henry Milani, D.O.
• George Gaw Moran, M.D.
• Michael Joseph Moran, M.D.
• Meghan Morrow, MD
• Scott M Multack, D.O.

• Specialist in La Grange Highlands, IL
• Providers in La Grange Highlands, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.