Provider Demographics
NPI:1285670737
Name:NAPERVILLE SURGICAL ASSOCIATES, LTD
Entity Type:Organization
Organization Name:NAPERVILLE SURGICAL ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIAZZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-355-5633
Mailing Address - Street 1:10 W MARTIN AVE
Mailing Address - Street 2:#225
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6535
Mailing Address - Country:US
Mailing Address - Phone:630-355-5633
Mailing Address - Fax:630-355-5215
Practice Address - Street 1:10 W MARTIN AVE
Practice Address - Street 2:#225
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6535
Practice Address - Country:US
Practice Address - Phone:630-355-5633
Practice Address - Fax:630-355-5215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0361139081Medicaid
IL202014Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER