NPIMap

Organization Active NPI

Central Illinois Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Decatur, IL
National Provider Identifier
1972572964
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
7002819 Issued in IL
Legal business name
CENTRAL ILLINOIS SURGERY CENTER, LLC
Practice address
304 W Hay St
Suite 114
Decatur, IL 62526-6328
Phone
(217) 876-8201
Fax
(217) 876-8202
NPI assigned
Mar 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Marshall F Brustein, M.D.
Title
President, Board of Directors
Phone
(217) 872-8204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 7002819 IL Primary

Addresses

Primary practice location

304 W Hay St
Suite 114
Decatur, IL 62526-6328

Mailing address

304 W Hay St
Suite 114
Decatur, IL 62526-6328
Phone (217) 876-8201

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972572964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W HAY ST",
            "address_2": "SUITE 114",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625266328",
            "telephone_number": "217-876-8201",
            "fax_number": "217-876-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W HAY ST",
            "address_2": "SUITE 114",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625266328",
            "telephone_number": "217-876-8201",
            "fax_number": "217-876-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ILLINOIS SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUSTEIN",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT, BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "217-872-8204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7002819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

Verify at the official NPI Registry.