NPIMap

Organization Active NPI

Berwyn Surgical Center LLC

  • Ambulatory Surgical Clinic/Center
  • Berwyn, IL
National Provider Identifier
1992086029
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
BERWYN SURGICAL CENTER LLC
Practice address
3253 S Harlem Ave
Ste. 1B
Berwyn, IL 60402-2996
Phone
(708) 788-3880
NPI assigned
Sep 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Authorized official

Name
Wajahat Akthar, D.C.
Title
Office Manager
Phone
(708) 788-3880

Specialties & licenses 1

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

Addresses

Primary practice location

3253 S Harlem Ave
Ste. 1B
Berwyn, IL 60402-2996

Mailing address

3253 S Harlem Ave
Ste. 1B
Berwyn, IL 60402-2996
Phone (708) 788-3880

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1992086029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3253 S HARLEM AVE",
            "address_2": "STE. 1B",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022996",
            "telephone_number": "708-788-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3253 S HARLEM AVE",
            "address_2": "STE. 1B",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022996",
            "telephone_number": "708-788-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERWYN SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-02",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "AKTHAR",
        "authorized_official_first_name": "WAJAHAT",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "708-788-3880",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.