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ELGIN GASTROENTEROLOGY ENDOSCOPY CENTER LLC NPI 1992875454


NPI Information

NPI: 1992875454
Provider Name: ELGIN GASTROENTEROLOGY ENDOSCOPY CENTER LLC

Doing Business As: THE ENDO CENTER OF ELGIN GASTROENTEROLOGY

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 14D2039676

Address:
745 FLETCHER DR FL 2
ELGIN, IL
ZIP 60123
Phone: (847) 888-1300
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ELGIN GASTROENTEROLOGY ENDOSCOPY CENTER LLC is an ambulatory surgical clinic center in Elgin, IL. ELGIN GASTROENTEROLOGY ENDOSCOPY CENTER LLC NPI is 1992875454. The provider is registered as an organization entity type.
The provider Is Doing Business As The Endo Center Of Elgin Gastroenterology.

The provider's business location address is:

745 FLETCHER DR FL 2
ELGIN, IL
ZIP 60123-747
Phone: (847) 888-1300
Fax: (847) 888-1341

The provider's authorized official is Sharon M Hohlfeld .
The authorized official title is Vp, Payer Contracting and has the following contact phone number (215) 589-9024.

The CLIA number assigned to this NPI record is 14D2039676 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/9/2006 and was last updated on 4/20/2020.


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
1261QA1903XClinic/CenterAmbulatory Surgical1710262ILLINOISYes

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
150438OTHERILLINOISBLUE SHIELD

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: 4/28/2024

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