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14D2136922 CLIA NUMBER - SSD MEDICAL GROUP INC

Laboratory Demographics

CLIA Number: 14D2136922

Facility Name: SSD MEDICAL GROUP INC

Facility Address:
12151 REGENCY PARKWAY, SUITE 12165
HUNTLEY, IL
ZIP 60142
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Facility Phone Number: 847 628-4751

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1932635083

Taxonomy: 302F00000X - Exclusive Provider Organization
(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.

CLIA Record

Field Name Field Value
CLIA Number 14D2136922
LAB Type Physician Office
Facility Name SSD MEDICAL GROUP INC
Street 12151 REGENCY PARKWAY, SUITE 12165
City HUNTLEY
State IL
ZIP 60142
Phone 847 628-4751
CertificateType 4
CertificateEffectiveDate 9/18/2023
CertificateExpirationDate 9/17/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024