SUMMIT MEDICAL CENTER S.C. NPI 1679744643

NPI Information

NPI: 1679744643
Provider Name: SUMMIT MEDICAL CENTER S.C.

Former Legal Business Name: SUMMIT MEDICAL CENTER

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
6252 S ARCHER RD
SUMMIT, IL
ZIP 60501
Phone: (708) 496-9549
Get Directions

SUMMIT MEDICAL CENTER S.C. is a primary care clinic center in Summit, IL. SUMMIT MEDICAL CENTER S.C. NPI is 1679744643. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Summit Medical Center.

The provider's business location address is:

6252 S ARCHER RD
SUMMIT, IL
ZIP 60501-720
Phone: (708) 496-9549
Fax: (708) 728-9429

The provider's authorized official is Ankit Shah .
The authorized official title is President and has the following contact phone number (708) 496-9549.

The CLIA number assigned to this NPI record is 14D1005753 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/18/2008 and was last updated on 8/29/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	036086195	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036086195	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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