WESTERN DIVERSEY SURGICAL CENTER
NPI 1265583934
Clinic/Center - Ambulatory Surgical in Chicago, IL
NPI Status: Active since January 16, 2007
Contact Information
2744 N WESTERN AVE
CHICAGO, IL
ZIP 60647
Phone: (773) 772-7726
Fax: (773) 772-3696
- Organization
- Clinic/Center
- Ambulatory Surgical
- Accepts Insurance
- CLIA Number: 14D0665170
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 12-22-2025
About WESTERN DIVERSEY SURGICAL CENTER
This page provides the complete NPI Profile along with additional information for Western Diversey Surgical Center, 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 1265583934 assigned on January 2007. The practitioner's primary taxonomy code is 261QA1903X with license number 7000037 (IL). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Western Diversey Surgical Center. The authorized official of this NPI record is Renlin Xia M.d. (Owner)
- NPI
- 1265583934
- Provider Legal Name
- AMERICAN WOMENS MEDICAL GROUP
- Other Organization Name
- WESTERN DIVERSEY SURGICAL CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2744 N WESTERN AVE CHICAGO, IL 60647
- Location Phone
- (773) 772-7726
- Location Fax
- (773) 772-3696
- Mailing Address
- 2744 N WESTERN AVE CHICAGO, IL 60647
- Mailing Phone
- (773) 772-7726
- Mailing Fax
- (773) 772-3696
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-16-2007
- Last Update Date
- 06-14-2019
- 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.
- 7000037
- 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:
- BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Elite Gold HMO 004 (Two free PCP visits, $0 Pediatric PCP visits) - HMO
- BSW Elite Gold HMO 012 - HMO
- BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Prime Silver HMO 008 (Two free PCP visits, $0 Pediatric PCP visit) - HMO
- BSW Prime Silver HMO 005 - HMO
- BSW Savers Bronze HMO H S A 006 - HMO
- BSW Vital Bronze HMO 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Vital Bronze HMO 009 (One free PCP visit, $0 Pediatric PCP visit) - HMO
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? 901 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- BlueCare Gold $25 PCP Copay ($5 Value Based Drug List) - PPO
- BlueCare Silver $45 PCP Copay ($5 Value Based Drug List) - PPO
- BlueDirect Bronze 100 HSA Eligible ($7500 Deductible / $5 Preventive Drug List) - PPO
- BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
- BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
- BlueEssential Catastrophic 100 $9200 Deductible - PPO
- BlueValue Bronze $50 PCP Copay (Standardized plan) - PPO
- BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
- BlueValue Silver $40 PCP Copay (Standardized plan) - PPO
- DakotaBlue Altru Gold ($5 Value Based Drug List) - PPO
- BlueSelect Bronze Basic - PPO
- BlueSelect Bronze Core - PPO
- BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
- BlueSelect Gold Core - PPO
- BlueSelect Gold HealthPlus - PPO
- BlueSelect Gold Standard without Kid's Dental - PPO
- BlueSelect Silver Classic - PPO
- BlueSelect Silver Classic without Kid's Dental - PPO
- BlueSelect Silver HealthPlus - PPO
- BlueSelect Silver HealthPlus without Kid's Dental - PPO
- Sanford Individual Simplicity $1,750 - PPO
- Sanford Individual Simplicity $3,500 - PPO
- Sanford Individual Simplicity $4,750 - PPO
- Sanford Individual Simplicity $6,000 - PPO
- Sanford Individual Simplicity $7,100 HSA Qualified - PPO
- Sanford Individual Simplicity $9,200 - PPO
- Sanford Individual Simplicity Standardized $1,500 - PPO
- Sanford Individual Simplicity Standardized $5,000 - PPO
- Sanford Individual Simplicity Standardized $7,500 - PPO
- Sanford Individual TRUE $1,750 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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 this NPI number is:
- CLIA Number
- 14D0665170
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- December 23, 2023
- Certificate Expiration Date
- December 22, 2025
- Laboratory Director
- TIAN XIA
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Western Diversey Surgical Center on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
Reviews for WESTERN DIVERSEY SURGICAL CENTER
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 6 | 5 | 5 | 8 | 3 | 9 | 3 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 12 | 5 | 10 | 8 | 6 | 9 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 2 + 5 + 1 + 0 + 8 + 6 + 9 + 6 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1265583934 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1861517906 | ELEUTERIO SUERTE MD Individual | Anesthesiology | 2744 N WESTERN AVE CHICAGO, IL 60647 (773) 772-7748 |
| 1104096031 | AMERICAN WOMEN'S PROFESSIONAL GROUP CORP Organization | Obstetrics & Gynecology | 2744 N WESTERN AVE CHICAGO, IL 60647 (773) 727-7726 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265583934, enumerated in the NPI registry as an "organization" on January 16, 2007
The provider is located at 2744 N Western Ave Chicago, Il 60647 and the phone number is (773) 772-7726
This medical organization specializes in Clinic/Center with taxonomy code 261QA1903X with a focus in Ambulatory Surgical
The provider might be accepting Accepts: Baylor Scott and White Health Plan, Blue Cross and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 14D0665170 for a "ambulatory surgery center" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on January 16, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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