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SURGICAL ASSOCIATES OF BLOOMINGTON ILLLTD NPI 1447355383


NPI Information

NPI: 1447355383
Provider Name: SURGICAL ASSOCIATES OF BLOOMINGTON, ILL,LTD
Classification: Surgery - 208600000X
Entity Type: Organization
Address:
1404 EASTLAND DRIVE
SUITE 104
BLOOMINGTON, IL
ZIP 61701
Phone: (309) 663-4351
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SURGICAL ASSOCIATES OF BLOOMINGTON, ILL,LTD is a surgery in Bloomington, IL. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. SURGICAL ASSOCIATES OF BLOOMINGTON, ILL,LTD NPI is 1447355383. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1404 EASTLAND DRIVE
SUITE 104
BLOOMINGTON, IL
ZIP 61701
Phone: (309) 663-4351
Fax: (309) 663-8359

The provider's authorized official is Lawrence A. Raines .
The authorized official title is President and has the following contact phone number (309) 663-4351.

The enumeration date for this NPI number is 9/14/2006 and was last updated on 2/1/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgeryYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1777460MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

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: 11/14/2023

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