MIDWEST ENDOSCOPY CENTER LLC NPI 1003036310

Clinic/Center (Ambulatory Surgical) in Naperville, IL

NPI 1003036310 Organization Clinic/Center Ambulatory Surgical CLIA Number 14D1069769 CLIA Certificate of Waiver

About MIDWEST ENDOSCOPY CENTER LLC

Midwest Endoscopy Center Llc is a provider established in Naperville, Illinois specializing in clinic/center (ambulatory surgical) . The NPI number of Midwest Endoscopy Center Llc is 1003036310 and was assigned on April 2007. The practitioner's primary taxonomy code is 261QA1903X with license number 7003127 (IL). The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Dinesh Jain M.d. (President)

The CLIA number of Midwest Endoscopy Center Llc is 14D1069769 registered as a "ambulatory surgery center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Midwest Endoscopy Center Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1003036310

Provider NameMIDWEST ENDOSCOPY CENTER LLC
Provider Location Address1243 RICKERT DR NAPERVILLE, IL 60540
Provider Mailing Address1243 RICKERT DR NAPERVILLE, IL 60540
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date04-27-2007
Last Update Date09-02-2008


Primary Taxonomy

Taxonomy Code261QA1903X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationAmbulatory Surgical
License No.7003127
License StateIL

Business Address

MIDWEST ENDOSCOPY CENTER LLC
1243 RICKERT DR
NAPERVILLE, IL
ZIP 60540
Phone: (630) 527-6450
Fax: (630) 527-6456

Get Directions


Mailing Address

MIDWEST ENDOSCOPY CENTER LLC
1243 RICKERT DR
NAPERVILLE, IL
ZIP 60540
Phone: (630) 527-6450
Fax: (630) 527-6456



Authorized Official

Authorized Official Name DINESH JAIN M.D.
Authorized Official TitlePRESIDENT
Authorized Official Phone(630) 527-6450

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003036310 is:

CLIA Number14D1069769
Facility TypeAMBULATORY SURGERY CENTER
Certificate TypeCertificate of Waiver

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
216499MEDICARE OSCAR/CERTIFICATION (06)IL

Other Providers at the same location


The following 15 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1164402244DR. DARREN A KASTIN M.D.
Individual
Internal Medicine (Gastroenterology)1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450
1568401529 SUSHAMA GUNDLAPALLI M.D.
Individual
Internal Medicine (Gastroenterology)1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450
1003857103 DINESH JAIN M.D.
Individual
Internal Medicine (Gastroenterology)1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450
1366483455 SCOTT A BERGER M.D.
Individual
Internal Medicine (Gastroenterology)1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450
1659549871 ANNE P LIVAK APN
Individual
Clinical Nurse Specialist1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450
1619125598DR. SHIVANI KIRILUK D.O.
Individual
Internal Medicine1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450
1144623752MS. MICHELLE ANN GULIK AGPCNP
Individual
Nurse Practitioner1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450
1003275249 YIBIN WANG
Individual
Dietitian, Registered1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450
1790821882MRS. SANDRA LYNN BERNKLAU APRN-BC
Individual
Nurse Practitioner (Family)1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 303-5611
1427453539 JESSICA HARNISH
Individual
Nurse Practitioner (Family)1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450
1336623875MRS. BONNIE KASTIN RD
Individual
Dietitian, Registered1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6456
1356816243MISS MAUREEN SARES ZAMORA APN
Individual
Nurse Practitioner (Primary Care)1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450
1194092031DR. ABHISHEK BHANDARI M.D.
Individual
Internal Medicine (Gastroenterology)1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450
1609427137MRS. PRINA PATEL APN, FNP-BC
Individual
Nurse Practitioner1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450
1770191496 KATHERINE HICKEY
Individual
Nurse Practitioner (Family)1243 RICKERT DR
NAPERVILLE, IL 60540
(630) 527-6450

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.