SUBURBAN SURGERY CENTER
NPI 1801876586
Surgery in Elmwood Park, IL

Q: What is Tiesenga Surgical Associates, S.C.'s NPI number?

The NPI number for Tiesenga Surgical Associates, S.C. is 1801876586. It was assigned to this organization in the NPPES registry on January 19, 2006. The provider is doing business as Suburban Surgery Center.

Q: What is Tiesenga Surgical Associates, S.C.'s specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Active since January 19, 2006CLIA 14D2060868 · Waiver

1950 N HARLEM AVE, ELMWOOD PARK, IL 60707(708) 453-6800(708) 453-3985 Get Directions Write a Review

NPPES record last updated: October 18, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 18, 2022, Oct 11, 2022 (2 updates tracked since 2022).

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About Suburban Surgery Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUBURBAN SURGERY CENTER (NPI 1801876586) is a healthcare organization registered as a surgery in Elmwood Park, Illinois and active in the NPI registry since January 2006. The organization holds a CLIA Waiver certificate valid through June 18, 2027 and lists Kathleen Burdett, Administrative Assistant, as its authorized official.

NPPES Registry Identity

NPI1801876586

Entity TypeOrganization

Primary Taxonomy208600000X

Legal Business NameTIESENGA SURGICAL ASSOCIATES, S.C.

Location Address1950 N HARLEM AVEElmwood Park, IL 60707

Mailing Address1950 N Harlem AveElmwood Park, IL 60707 · (708) 453-6800 · Fax (708) 453-3985

Phone(708) 453-6800

Fax(708) 453-3985

Organization SubpartNo

Authorized OfficialKathleen BurdettAdministrative Assistant · (708) 453-6800

Enumeration DateJanuary 19, 2006

Last NPPES UpdateOctober 18, 20222 updates tracked since enumeration

NPPES CertifiedOctober 18, 2022

✔ NPI 1801876586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in IL · 042000966

Definition

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.

Also ListedSurgery · Vascular SurgeryTaxonomy 2086S0129X · License 042000966 (IL)

1950 N HARLEM AVE, Elmwood Park, IL 60707

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Other Names 1

Doing Business AsSuburban Surgery Center

Other Identifiers 3

Other0160377350IL · Bcbs

Other950730IL · Medicare Practice

OtherCI4143IL · Rr Mcr

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2060868

Tiesenga Surgical Associates S C · Elmwood Park, IL

Active · expires Jun 18, 2027

CLIA Number14D2060868

Laboratory TypePhysician Office

Certificate Effective DateJune 19, 2025

Certificate Expiration DateJune 18, 2027

Laboratory DirectorFrederick M. Tiesenga

Laboratory Phone(708) 453-6800

Laboratory LocationTiesenga Surgical Associates S C1950 N Harlem, Elmwood Park, IL 60707

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEDICAL ASSOCIATES OF ILLINOIS SC

Internal Medicine