ADVANCED AESTHETICS SURGERY & LASER CENTER, P.C. (NPI# 1366620064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366620064 |
| Entity Type | Organization |
| Organization Name | ADVANCED AESTHETICS SURGERY & LASER CENTER, P.C. |
| Practice Address |
2111 West Park Ct. Champaign IL 61821 |
| Mailing Address |
1702 Mullikin Dr Champaign IL 61822-8305 |
| Practice Telephone | 2173563850 |
| Practice Fax Number | 2173563876 |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2018-01-08 |
| Authorized Official Name | DR. JAMES M KURLEY (PRESIDENT/MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2173563850 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
060.007842 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | STATE OF ILLINOIS | 060.007842 | 01 |
| Street Address |
2111 WEST PARK CT. |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326532888 | Cunningham Children's Home of Urbana Il | Residential Treatment Facility, Emotionally Disturbed Children | 1303 N. Cunningham Avenue, Urbana, IL 61821 | 2018-06-19 |
| 1184008708 | Seunghyun Jae | Dentist | 1905 W Springfield Ave, Champaign, IL 61821 | 2015-07-14 |
| 1457698169 | Mohamad Ata | Registered Nurse | 1802 S. Mattis, Champaign, IL 61821 | 2013-01-15 |
| 1609124338 | Lolitia Rosanna Newman | Social Worker | 1508 Powers Ln., Champaign, IL 61821 | 2012-08-28 |
| 1679850887 | Kirk Donald Gohsman | Counselor | 106 S. Country Fair Drive, Suite C, Champaign, IL 61821 | 2011-11-16 |
| 1598054777 | Delbert William Nelson Jr. | Psychiatry & Neurology | 2115 Galen Dr, Champaign, IL 61821 | 2011-03-28 |
| 1790946929 | Rdi Vein LLC | Clinic/Center | 2502 Galen Drive, Suite 101, Champaign, IL 61821 | 2008-06-20 |
| 1033398482 | Huey's Home Medical, Inc | Durable Medical Equipment & Medical Supplies | 1207 S Mattis Ave Ste 1, Champaign, IL 61821 | 2007-11-01 |
| 1265630537 | Elizabeth Catherine Tingley | Psychologist | Department of Psychiatry and Psychology-carle Physician, 1802 S. Mattis, Champaign, IL 61821 | 2007-07-06 |
| 1306062922 | Elizabeth Wagner | Counselor | 105 N Fair St, Champaign, IL 61821 | 2007-04-18 |
| Find all providers in zip 61821 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356400782 | Champaign Surgicenter, LLC | Clinic/Center | 3103 Fields South Dr, Champaign, IL 61822-3743 | 2006-12-08 |
| 1538332648 | Christie Clinic Amblatory Surgery Center LLC | Clinic/Center | 101 W University Ave, Champaign, IL 61820-3909 | 2008-04-09 |
| 1376720383 | Midwest Surgical Center | Clinic/Center | 2125 S Neil St, Champaign, IL 61820-7266 | 2008-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184245375 | Specialty Surgicare, Ltd | Clinic/Center | 500 W Golf Rd Ste 102, Schaumburg, IL 60195-3503 | 2020-04-29 |
| 1245862002 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 3301 Broadway St., Quincy, IL 62301 | 2020-02-10 |
| 1619519535 | Anderson Surgery Center LLC | Clinic/Center | 3403 Anderson Healthcare Drive, Edwardsville, IL 62025 | 2019-10-11 |
| 1922664622 | Premier Cardiac Surgery Center, LLC | Clinic/Center | 11560 S Kedzie Ave Ste 102, Merrionette Park, IL 60803-4517 | 2019-05-17 |
| 1487115804 | Ontario Street Operatory Fac | Clinic/Center | 22 W Ontario Street Operatory, Chicago, IL 60654 | 2019-03-28 |
| 1477017333 | Ontario Street Operatory | Clinic/Center | 22 W Ontario St, Chicago, IL 60654-5169 | 2019-01-24 |
| 1407329501 | Chicago Cosmetic Surgery Institute | Clinic/Center | 2335 S Michigan Ave, Chicago, IL 60616-2104 | 2019-01-10 |
| 1538647474 | Palos Health Surgery Center, LLC | Clinic/Center | 15300 West Ave Ste 260, Orland Park, IL 60462-4600 | 2018-08-02 |
| 1013493824 | Ann & Robert H. Lurie Children's Hospital of Chicago | Clinic/Center | 1121 Techny Rd, Northbrook, IL 60062-5503 | 2018-07-15 |
| 1619469244 | Rush Oak Brook Surgery Center, LLC | Clinic/Center | 2011 York Road, Suite 3000, Oak Brook, IL 60521 | 2018-05-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.