Tiesenga Surgical Associates, S.C.
NPI 1801876586ActiveOrganization· Surgery· Elmwood Park, IL
Surgery in Elmwood Park, Illinois, registered in NPPES in January 2006. The authorized official on file is Kathleen Burdett, Administrative Assistant. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1801876586 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 19, 2006 |
| Last updated in NPPES | Oct 18, 2022 |
| Certified by provider | Oct 18, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | 042000966 | IL |
| Surgery, Vascular Surgery | 2086S0129X | 042000966 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL) |
|---|
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