Provider Demographics
NPI:1376567958
Name:AMERICAN SURGEONS GROUP INC
Entity Type:Organization
Organization Name:AMERICAN SURGEONS GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:EVE
Authorized Official - Last Name:SHAUGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:708-799-7500
Mailing Address - Street 1:1757 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1812
Mailing Address - Country:US
Mailing Address - Phone:708-799-7500
Mailing Address - Fax:815-215-1144
Practice Address - Street 1:1757 RIDGE RD
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1812
Practice Address - Country:US
Practice Address - Phone:708-799-7500
Practice Address - Fax:708-798-4563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCK4095OtherRAILROAD MEDICARE
IL01632534OtherBCBS
IN253190Medicare PIN
ILCK4095OtherRAILROAD MEDICARE
IL213316Medicare PIN
IL202569Medicare PIN