FULLERTON SURGERY CENTER INC
NPI 1285675678
Clinic/Center - Ambulatory Surgical in Chicago, IL
NPI Status: Active since June 09, 2006
Contact Information
4849 W FULLERTON AVE
CHICAGO, IL
ZIP 60639
Phone: (773) 237-2900
Fax: (773) 622-0769
- Organization
- Clinic/Center
- Ambulatory Surgical
- Accepts Insurance
- CLIA Number: 14D0998861
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-25-2028
About FULLERTON SURGERY CENTER INC
This page provides the complete NPI Profile along with additional information for Fullerton Surgery Center Inc, a provider established in Chicago, Illinois operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1285675678 assigned on June 2006. The practitioner's primary taxonomy code is 261QA1903X with license number 042618689 (IL). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's other name is Fullerton Surgery Center Inc. The authorized official of this NPI record is Naser Rustom M.d. (Owner/medical Director)
- NPI
- 1285675678
- Provider Legal Name
- FULLERTON SURGERY CENTER LTD
- Other Organization Name
- FULLERTON SURGERY CENTER INC
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 4849 W FULLERTON AVE CHICAGO, IL 60639
- Location Phone
- (773) 237-2900
- Location Fax
- (773) 622-0769
- Mailing Address
- 4849 W FULLERTON AVE CHICAGO, IL 60639
- Mailing Phone
- (773) 237-2900
- Mailing Fax
- (773) 622-0769
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-09-2006
- Last Update Date
- 02-06-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Ambulatory Surgical
- Taxonomy Code
- 261QA1903X
- Type
- Ambulatory Health Care Facilities
- License No.
- 042618689
- License State
- IL
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Principal Bronze HSA - EPO
- Principal Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope
Biopsy of large bowel using a flexible endoscope
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
This service was performed 21 times for 21 patientsA biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
This service was performed 11 times for 11 patientsCLIA 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 this NPI number is:
- CLIA Number
- 14D0998861
- Facility Type
- Physician Office
- Certificate Effective Date
- April 26, 2026
- Certificate Expiration Date
- April 25, 2028
- Laboratory Director
- NASER RUSTOM MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fullerton Surgery Center Inc 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.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1285675678, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 15 providers are registered at the same or a nearby location.
CHICAGO, IL 60639
CHICAGO, IL 60639
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1285675678, enumerated as an "organization" on June 09, 2006.
The provider is located at 4849 W FULLERTON AVE CHICAGO, IL 60639 and the phone number is (773) 237-2900.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter Health. Please consult your insurance carrier or call the provider to verify.
