TLC MEDICAL GROUP, S.C. (NPI# 1487836284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487836284 |
| Entity Type | Organization |
| Organization Name | TLC MEDICAL GROUP, S.C. |
| Other Organization Name | TLC WOMEN'S HEALTH S.C. |
| Practice Address |
40w222 La Fox Road Suite J1 Saint Charles IL 60175 |
| Practice Telephone | 6305139160 |
| Practice Fax Number | 6305139617 |
| Mailing Telephone | 6305139160 |
| Mailing Fax Number | 6305139617 |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2019-01-14 |
| Authorized Official Name | DR. JONATHAN SONG (MANAGING PHYSICIAN) |
| Authorized Official Telephone | 6305139160 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 036104024 | IL | Allopathic & Osteopathic Physicians |
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
03106052 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | NPI NUMBER | 1851452775 | 01 |
| IL | BLUECROSS BLUE SHIELD | 4532123 | 01 |
| Other Name | Type Code |
|---|---|
| TLC Women's Health S.C. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649334186 | Tlc Medical Group, S.c. | Obstetrics & Gynecology | 2455 Dean St, Suite A, Saint Charles, IL 60175-4830 | 2006-12-20 |
| Street Address |
40W222 LA FOX ROAD SUITE J1 |
| City | SAINT CHARLES |
| State | IL |
| Zip Code | 60175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831280783 | Healthguard Medical Network Sc | Internal Medicine | 40w222 La Fox Road, Suite K, Saint Charles, IL 60175-7625 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740733138 | Ryan Paul Kuebler | Dentist | 40w320 La Fox Rd., Suite D, St Charles, IL 60175 | 2016-08-02 |
| 1346602554 | Erica Witkowski | Specialist/Technologist | 6n 370 Crescent Lane, Saint Charles, IL 60175 | 2016-03-26 |
| 1437495728 | Bradley S Murison | Physical Therapist | 3381 W State St., Suite 100, St Charles, IL 60175 | 2012-12-14 |
| 1942507355 | Fox River & Countryside Fire/rescue District | Ambulance | 35w350 Carl Lee Road, St Charles, IL 60175 | 2011-02-21 |
| 1871825984 | Fay E Jackson | Counselor | 3140 W Route 64, St. Charles, IL 60175 | 2010-02-01 |
| 1801126941 | Philip James Kocisko | Counselor | 3140 W. Route 64, Saint Charles, IL 60175 | 2010-01-13 |
| 1891971529 | Caroline M Bollentino | Speech-Language Pathologist | 40w310 La Fox Rd, Suite A1-b1, St Charles, IL 60175 | 2008-01-11 |
| 1770783599 | Joy O Urubusi | Psychiatry & Neurology | 3825 Campton Hills Road, St Charles, IL 60175 | 2007-07-19 |
| 1225236052 | Anna Almase Medina | Dentist | 2445 Dean, 1c, St Charles, IL 60175 | 2007-07-03 |
| 1467666453 | Shelly Sinatra | Nurse Practitioner | 3310 W. Main St, Suite 200, St. Charles, IL 60175 | 2007-05-09 |
| Find all providers in zip 60175 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851452775 | Jonathan Y Song | Obstetrics & Gynecology | 2455 Dean St, Suite A, Saint Charles, IL 60175-4830 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477167112 | Omnidoc Health Inc | Obstetrics & Gynecology | 351 Greenleaf St Ste E, Park City, IL 60085-5701 | 2020-09-01 |
| 1396142857 | Illinois Institute of Gynecology and Advanced Pelvic Surgery, Sc | Obstetrics & Gynecology | 1351 W Belmont Ave, Chicago, IL 60657-7195 | 2014-11-28 |
| 1902171325 | Womens Health Institute of Illinois Ltd | Obstetrics & Gynecology | 10762 W 167th St, Orland Park, IL 60467-5434 | 2012-03-19 |
| 1609148303 | Archimedes Sison Diamante | Obstetrics & Gynecology | 949 N Euclid Ave, Oak Park, IL 60302-1319 | 2012-01-27 |
| 1376821025 | Prairieview Gyn LLC | Obstetrics & Gynecology | 3929 Morgan Trl, Bourbonnais, IL 60914-4738 | 2011-07-29 |
| 1932493236 | Integrative Medical Options LLC | Obstetrics & Gynecology | 305 N. 2nd St, St. Charles, IL 60174 | 2011-06-03 |
| 1477715142 | Michel Medical Assoc., S.c. | Obstetrics & Gynecology | 2600 S Michigan Ave Ste 314, Chicago, IL 60616-2860 | 2008-06-25 |
| 1477727550 | All Women's Medical Center | Obstetrics & Gynecology | 3140 W Irving Prk. Rd, Chicago, IL 60618 | 2008-04-18 |
| 1053581371 | S L Fuentes Md D M Milanes Md Sc | Obstetrics & Gynecology | 107 Center St, Grayslake, IL 60030-1532 | 2008-03-03 |
| 1477731784 | Marianna Vardaka Md Inc | Obstetrics & Gynecology | 1087 Solutions Ctr, Chicago, IL 60677-1000 | 2008-02-08 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CHARLES |
| Zip Code | 60175 |
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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.