AMBULATORY SURGICAL TREATMENT CENTER PROFILE …...SURGERY AREA SURGERIES TOTAL OPERATING ROOM...

Hauser-Ross Ambulatory Surgical Center SycamoreAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018

0-14 years 115-44 years 4145-64 years 35865-74 years 44575+ years 415

TOTAL 1,260

835

412567470

1,492

976

7701,012

885

2,752

NUMBER OF PATIENTS BY AGE GROUP

AGE MALE FEMALE TOTAL

Medicaid 107Medicare 810Other Public 8Insurance 313Private Pay 22Charity Care 0

TOTAL 1,260

109978

6380190

1,492

2161,788

14693

410

2,752

NUMBER OF PATIENTS BY PRIMARY PAYMENT SOURCE

PAYMENT SOURCE MALE FEMALE TOTAL

NET REVENUE BY PAYOR SOURCE FOR FISCAL YEAR

70,119734,751 1,589 596,655 945,998 2,349,112

3.0%31.3% 0.1% 25.4% 40.3%

Medicare Medicaid Other Public Private Insurance Private Pay TOTALS

0

Charity Care

Expense

0%

Charity CareExpense as % of

Total Net Revenue100.0%

Reference Numbers

001

7003197

037

Hauser-Ross Ambulatory Surgical Center

2515 Klein Road

Sycamore, IL 60178

Administrator

Lisa Nagle

Date Complete5/6/2019

Registered Agent

C T Corporation System

Property Owner

MAE Sycamore Holding

Legal Owner(s)

Facility Id

Health Service Area Planning Service Area

Contact Person Telephone

Lisa Nagle 815-756-8574

Number of Operating Rooms 4

Number of Recovery Stations Stage 1 4


Exam Rooms 1

Procedure Rooms 2

Administrator 1.00Physicians 0.00

Director of Nurses 1.00Registered Nurses 9.00Certified Aides 1.00Other Health Profs. 4.00Other Non-Health Profs 2.00

TOTAL 18.00

STAFFING PATTERNS

PERSONNEL FULL-TIME EQUIVALENTS

Nurse Anesthetists 0.00

Type of Ownership

Limited Liability Company (RA required)

HOSPITAL TRANSFER RELATIONSHIPS

HOSPITAL NAME NUMBER OF PATIENTS

Kishwaukee Hospital Sycamore, IL 6




Exam Rooms 1

Procedure Rooms 2

of 292 2/7/2020

Source:Ambulatory Surgical Treatment Center Questionnaire for 2018, Illinois Department of Public Health, Health Systems Development

Hauser-Ross Ambulatory Surgical Center SycamoreAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018

Leading Locations of Patient Residence

Zip Code City County Patients

SURGERY AREA SURGERIESTOTAL

OPERATING ROOM UTILIZATION FOR THE REPORTING YEAR

SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY

TIME (HOURS) TIME (HOURS)SURGERY

TOTAL AVERAGECASE TIME

(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.000 0.00 0.00General 0.00 0.000 0.00 0.00Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 0.00 0.000 0.00 0.00Ophthalmology 1,399.25 628.501865 2027.75 1.09Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 0.00 0.000 0.00 0.00Otolaryngology 0.00 0.000 0.00 0.00Pain Management 0.00 0.000 0.00 0.00Plastic Surgery 0.00 0.000 0.00 0.00Podiatry 0.00 0.000 0.00 0.00Thoracic 0.00 0.000 0.00 0.00Urology 0.00 0.000 0.00 0.00

1,399.25 628.50TOTAL 1865 2027.75 1.09

60115 DeKalb 535De Kalb

60178 DeKalb 348Sycamore

61068 Ogle 145Rochelle

61061 Ogle 73Oregon

60548 DeKalb 71Sandwich

60135 DeKalb 71Genoa

61021 Lee 66Dixon

61008 Boone 65Belvidere

60152 McHenry 53Marengo

60145 DeKalb 41Kingston

60112 DeKalb 39Cortland

60140 Kane 39Hampshire

61108 Winnebago 36Rockford

61081 Whiteside 35Sterling

61054 Ogle 35Mount Morris

61032 Stephenson 34Freeport

60552 LaSalle 34Somonauk

60151 Kane 32Maple Park

60545 Kendall 31Plano

60518 LaSalle 30Earlville

60150 DeKalb 30Malta

60142 McHenry 29Huntley

60556 DeKalb 28Waterman

61010 Ogle 28Byron


PROCEDURE ROOM UTILIZATION FOR THE REPORTING YEAR

PREP ANDCLEAN-UP

TIME (HOURS)SURGERY


TOTAL AVERAGECASE TIME(HOURS)ROOMS

PROCEDURE

Cardiac Catheterizat 0 0 0 0.0000

Gastro-Intestinal 0 0 0 0.0000

Laser Eye 887 70 136.7 0.23206.72

Pain Management 0 0 0 0.0000

of 292 2/7/2020


Midland Surgical Center LLC Sycamore AMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 500

551332064534

473

12628737110980

973




TOTAL 500

39905

33810

473

80186

9695

30

973




56,327177,175 10,954 2,797,887 6,917 3,049,260

1.8%5.8% 0.4% 91.8% 0.2%


0

Charity Care

Expense

0%



Reference Numbers

001

7003148

037

Midland Surgical Center LLC

2120 Midlands Ct.

Sycamore , IL 60178

Administrator

Patricia Sulaver


Registered Agent

Steven Glasgow

Property Owner

TMSCP

Legal Owner(s)

Facility Id



Patricia Sulaver 815-748-0393




Exam Rooms 0

Procedure Rooms 0



TOTAL 14.40

STAFFING PATTERNS



Type of Ownership




Kishwaukee Community Hospital 2




Exam Rooms 0

Procedure Rooms 0

Joseph Scianna MD

Kishwaukee Hospital

Michele Glasgow MD

Rajeev Jain MD

Regent Surgical Health

Sajit Bux MD

Shane York DPM

Steven Glasgow MD

Tony Choi MD

of 292 2/7/2020


Midland Surgical Center LLC Sycamore AMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.000 0.00 0.00General 0.00 0.000 0.00 0.00Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 2.25 1.003 3.25 1.08Ophthalmology 0.00 0.000 0.00 0.00Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 711.00 220.00577 931.00 1.61Otolaryngology 196.00 60.50246 256.50 1.04Pain Management 7.50 2.0013 9.50 0.73Plastic Surgery 1.25 0.501 1.75 1.75Podiatry 98.50 20.5087 119.00 1.37Thoracic 0.00 0.000 0.00 0.00Urology 36.00 7.7546 43.75 0.95

1,052.50 312.25TOTAL 973 1364.75 1.40

60115 265De Kalb

60178 190Sycamore

61068 78Rochelle

60135 65Genoa

60112 33Cortland

60145 20Kingston

60150 20Malta

61081 19Sterling

60548 18Sandwich

60151 18Maple Park

61021 17Dixon

60556 17Waterman

60146 15Kirkland

60530 8Lee

60550 8Shabbona

61006 8Ashton

60140 8Hampshire

60554 7Sugar Grove

61071 7Rock Falls

60531 6Leland

61020 6Davis Junction

60552 6Somonauk

61008 5Belvidere

60175 5St. Charles



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


NorthPointe Surgery Center RoscoeAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 889

0107409381376

1,273

0203690635634

2,162




TOTAL 889

12760

0499

20

1,273

181,218

0912

140

2,162




12,910967,538 0 2,720,895 0 3,701,343

0.3%26.1% 0.0% 73.5% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

001

7003209

201

NorthPointe Surgery Center

5605 E Rockton Road

Roscoe, IL 61073

Administrator

Timothy M. McKevett


Registered Agent

Rodney Kimes

Property Owner

Legal Owner(s)

Facility Id



Mike Bua 608-364-5377




Exam Rooms 0

Procedure Rooms 2



TOTAL 34.00

STAFFING PATTERNS



Type of Ownership

Other Not For Profit Ownership



Beloit Health System Hospital 1Swedish American Hospital, Rockford 0




Exam Rooms 0

Procedure Rooms 2

of 292 2/7/2020


NorthPointe Surgery Center RoscoeAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


322.33 170.23TOTAL 859 492.56 0.57

53511 Rock 1139

61080 Winnebago 195South Beloit

61072 Winnebago 157Rockton

61073 Winnebago 142Roscoe

53525 Green 99

53567 Rock 83

53548 Rock 43

61115 Winnebago 34Machesney Park

53545 Rock 34

53520 Green 15


53576 Rock 12


61065 Boone 11Poplar Grove


53566 Green 9

61011 Boone 9Caledonia


53115 Walworth 8

53121 Walworth 7

53563 Rock 7

53585 Walworth 7





PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE


Gastro-Intestinal 640 299.95 108.8 0.64408.751

Laser Eye 0 0 0 0.0000

Pain Management 663 62.33 232.05 0.44294.381

of 292 2/7/2020


Rockford Ambulatory Surgery Center RockfordAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,025

129278775

1,025717

2,924

272384

1,2961,7401,257

4,949



Medicaid 0Medicare 1,210Other Public 0Insurance 773Private Pay 37Charity Care 0

TOTAL 2,020

01,711

51,042

1710

2,929

02,921

51,815

2080

4,949




01,972,419 4,760 4,590,051 2,191,418 8,758,648

0.0%22.5% 0.1% 52.4% 25.0%


0

Charity Care

Expense

0%



Reference Numbers

001

7001928

201

Rockford Ambulatory Surgery Center

1016 Featherstone Road

Rockford, IL 61107-5902

Administrator

Steven A. Gunderson, DO


Registered Agent

W. Stephen Minore, MD

Property Owner

Legal Owner(s)

Facility Id



Steven A. Gunderson, DO 815-231-5450




Exam Rooms 1

Procedure Rooms 2



TOTAL 38.50

STAFFING PATTERNS



Type of Ownership

Limited Liability Partnership (RA required)



UW SwedishAmerican Hospital, Rockford, IL 3




Exam Rooms 1

Procedure Rooms 2

AM Partnership

Brent Horsley, MD

Carolyn Lowry

CVW Partnership

Dr & Mrs. Stephen Croy

Gary Eberle, MD

Guilford Group, LLP

Gunderson Trust TG-96

James Dougherty, DO

Joseph Fanara, DPM

JTJ, LLC

LJM Legacy Trust 2002

LJM Legacy Trust 2002

Maria Laporta Trust

RAA, LLC

Rainsford Way Partnership

RASTC, Ltd

Rhonda Arends

Seeber Foot Clinic, LTD

Steven Gunderson, DO

SwedishAmerican Hospital

Thomas Danaher, MD

of 292 2/7/2020


Rockford Ambulatory Surgery Center RockfordAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 1.00 1.002 2.00 1.00Dermatology 2.75 1.002 3.75 1.88Gastroenterology 3.25 2.506 5.75 0.96General 85.00 45.50109 130.50 1.20Laser Eye Surgery 2.00 1.002 3.00 1.50Neurology 13.50 9.7523 23.25 1.01OB/Gynecology 83.50 44.25106 127.75 1.21Ophthalmology 1,273.75 76,852.502580 78126.25 30.28Oral/Maxillofacial 214.50 57.50185 272.00 1.47Orthopedic 426.75 162.50390 589.25 1.51Otolaryngology 212.00 95.50229 307.50 1.34Pain Management 98.00 28.5068 126.50 1.86Plastic Surgery 539.00 98.00235 637.00 2.71Podiatry 341.50 118.00283 459.50 1.62Thoracic 0.00 0.000 0.00 0.00Urology 12.25 6.2515 18.50 1.23

3,308.75 77,523.75TOTAL 4235 80832.50 19.09

61107 512Rockford

61008 385Belvidere

61108 352Rockford

61109 345Rockford

61111 305Rockford

61115 275Machesney Park

61114 248Rockford

61073 235Roscoe

61103 210Rockford

61104 141Rockford

61102 139Rockford

61072 132Rockton

61016 127Cherry Valley

61065 118Poplar Grove

61101 113Rockford

61010 104Byron

61080 80South Beloit

61032 75Freeport

61088 72Winnebago

61011 70Caledonia

61061 53Oregon

61068 53Rochelle

61021 51Dixon

61019 49Davis



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000

Multi-Gyn 6 2.25 1.5 0.633.75

of 292 2/7/2020


Rockford Endoscopy Center RockfordAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018

0-14 years 015-44 years 70645-64 years 3,77565-74 years 1,84275+ years 641

TOTAL 6,964

01,1294,4162,255

715

8,515

01,8358,1914,0971,356

15,479



Medicaid 629Medicare 2,289Other Public 166Insurance 3,774Private Pay 72Charity Care 77

TOTAL 7,007

1,0212,909

374,203

112190

8,472

1,6505,198

2037,977

184267

15,479




426,5102,197,358 70,899 7,648,067 724,961 11,067,795

3.9%19.9% 0.6% 69.1% 6.6%


142,056

Charity Care

Expense

1%



Reference Numbers

001

7001761

201

Rockford Endoscopy Center

401 Roxbury Road

Rockford, IL 61107

Administrator

Ken Folz


Registered Agent

Phil Frankfort

Property Owner

Legal Owner(s)

Facility Id



Erica Natal 815-484-7930




Exam Rooms 0

Procedure Rooms 4



TOTAL 44.60

STAFFING PATTERNS



Type of Ownership

Corporation (RA required)



OSF ST Anthony Hospital, Rockford IL 6Swedish American Hospital, Rockford IL 4




Exam Rooms 0

Procedure Rooms 4

Aaron Shiels, MD

Brad Bowyer, MD

Chandrashekhar Thukral,M

Clinton Snedegar, MD

George Tannous, MD

Ilche Nonevski, MD

John DeGuide, MD

Joseph Vicari, MD

Kevin Peifer, MD

Michael Manley, MD

Steven Ikenberry, MD

Sumeet Tewani, MD

Sunil Patel, MD

of 292 2/7/2020


Rockford Endoscopy Center RockfordAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00





61115 Winnebago 937Machesney Park


61073 Stephenson 836Roscoe






61072 Stephenson 400Rockton

61010 Ogle 399Byron

61065 Boone 388Poplar Grove

61016 Village of Cher 311Cherry Valley

61080 Winnebago 239South Beloit

61088 Ogle 234Winnebago

61061 Winnebago 212Oregon

61068 Ogle 204Rochelle

61084 Ogle 164Stillman Valley

60152 155Marengo

61011 Boone 147Caledonia

61063 Winnebago 135Pecatonica



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Rockford Orthopedic Surgery Center RockfordAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,963

58496

1,128336127

2,145

1311,0782,077

592230

4,108



Medicaid 36Medicare 350Other Public 0Insurance 1,568Private Pay 9Charity Care 0

TOTAL 1,963

62504

01,578

10

2,145

98854

03,146

100

4,108




49,7502,079,909 0 15,784,848 1,125,118 19,039,625

0.3%10.9% 0.0% 82.9% 5.9%


0

Charity Care

Expense

0%



Reference Numbers

001

7002835

201

Rockford Orthopedic Surgery Center

346 Roxbury Road

Rockford, IL 61107

Administrator

Donald Schreiner


Registered Agent

Jan H. Ohlander

Property Owner

Legal Owner(s)

Facility Id



Stacey Halverson 815-381-7331




Exam Rooms

Procedure Rooms

AdministratorPhysicians

Director of NursesRegistered Nurses 23.12Certified Aides 17.48Other Health Profs.Other Non-Health Profs 6.30

TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




OSF Saint Francis, Inc., Rockford 8




Exam Rooms

Procedure Rooms

of 292 2/7/2020


Rockford Orthopedic Surgery Center RockfordAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.000 0.00 0.00General 0.00 0.000 0.00 0.00Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 0.00 0.000 0.00 0.00Ophthalmology 0.00 0.000 0.00 0.00Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 2,537.25 1,404.003587 3941.25 1.10Otolaryngology 0.00 0.000 0.00 0.00Pain Management 47.75 22.5071 70.25 0.99Plastic Surgery 0.00 0.000 0.00 0.00Podiatry 618.00 171.50450 789.50 1.75Thoracic 0.00 0.000 0.00 0.00Urology 0.00 0.000 0.00 0.00

3,203.00 1,598.00TOTAL 4108 4801.00 1.17

61008 351Belvidere

61107 294Rockford

61108 262Rockford

61073 235Roscoe

61115 231Machesney Park

61109 227Rockford

61111 218Rockford

61114 139Rockford

61032 126Freeport

61103 124Rockford

61072 115Rockton

61065 109Poplar Grove

61101 96Rockford

61010 92Byron

61102 79Rockford

61080 71South Beloit

61088 69Winnebago

61104 69Rockford

61021 63Dixon

61016 60Cherry Valley

53511 58

61061 55Oregon

61011 41Caledonia

61063 39Pecatonica



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Center for Health Ambulatory Surgery Center, LLC PeoriaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018

0-14 years 37115-44 years 40545-64 years 97865-74 years 1,06475+ years 790

TOTAL 3,608

316530

1,3181,507

849

4,520

687935

2,2962,5711,639

8,128




TOTAL 3,608

832,349

182,016

486

4,520

1294,086

1133,711

818

8,128




121,3785,696,211 274,704 17,203,944 169,360 23,465,597

0.5%24.3% 1.2% 73.3% 0.7%


57,705

Charity Care

Expense

0%



Reference Numbers

002

7003124

143

Center for Health Ambulatory Surgery Center, LLC

8800 North State Route 91

Peoria, IL 61615-9473

Administrator

Thomas J Feldman


Registered Agent

Illinois Corporation Service C

Property Owner

OSF Healthcare SFMC

Legal Owner(s)

Facility Id



Thomas J Feldman 309-683-5480




Exam Rooms 0

Procedure Rooms 0

Administrator 1.00Physicians

Director of Nurses 1.00Registered Nurses 26.00Certified AidesOther Health Profs. 20.00Other Non-Health Profs 18.00

TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




OSF Healthcare St. Francis Med Center - Peoria, IL 7




Exam Rooms 0

Procedure Rooms 0

Illinois Eye Center

Musculoskeletal Invstmt

OSF Healthcare SFMC

Peoria Surgical Group, Ltd

of 292 2/7/2020







SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.000 0.00 0.00General 872.50 872.75970 1745.25 1.80Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 101.00 100.75124 201.75 1.63Ophthalmology 1,730.25 1,730.254072 3460.50 0.85Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 1,310.75 1,310.751231 2621.50 2.13Otolaryngology 550.00 547.00752 1097.00 1.46Pain Management 59.75 59.7537 119.50 3.23Plastic Surgery 422.50 422.75449 845.25 1.88Podiatry 222.00 222.50194 444.50 2.29Thoracic 0.00 0.000 0.00 0.00Urology 128.25 128.25299 256.50 0.86

5,397.00 5,394.75TOTAL 8128 10791.75 1.33

61614 543Peoria

61611 512East Peoria

61550 496Morton

61571 496Washington

61554 489Pekin

61604 450Peoria

61615 429Peoria

61520 264Canton

61523 257Chillicothe

61607 253Bartonville

61548 245Metamora

61401 236Galesburg

61525 220Dunlap

61603 134Peoria

61605 114Peoria

61517 113Brimfield

61536 89Hanna City

61610 87Peoria

61547 79Mapleton

61568 79Tremont

61443 79Kewanee

61559 78Princeville

61528 76Edwards

61531 70Farmington



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020




TOTAL 62

39

24102

48

3275718

5

110




TOTAL 62

2120

3400

48

2191

8800

110




1,46318,286 0 473,188 0 492,937

0.3%3.7% 0.0% 96.0% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

002

7003220

143

Center for Health Ambulatory Surgery Center, LLC -

303 N William Kumpf Blvd, 2nd Floor

Peoria, IL 61605

Administrator

Thomas J Feldman


Registered Agent


Property Owner

OSF Healthcare SFMC

Legal Owner(s)

Facility Id



Thomas J Feldman 309-683-5480




Exam Rooms 0

Procedure Rooms 0


Director of NursesRegistered Nurses 0.60Certified AidesOther Health Profs. 0.70Other Non-Health Profs 0.40

TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




OSF Healthcare St Francis Med Cntr - Peoria, IL 0




Exam Rooms 0

Procedure Rooms 0

Illinois Eye Center

Musculoskeletal Investmen

OSF Healthcare SFMC

Peoria Surgical Group, Ltd

of 292 2/7/2020







SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


112.00 112.00TOTAL 110 224.00 2.04

61611 10East Peoria

61554 8Pekin

61614 8Peoria

61548 6Metamora

61615 6Peoria

61604 6Peoria

61571 6Washington

61523 4Chillicothe

61401 4Galesburg

61434 3Galva

61547 3Mapleton

61517 3Brimfield

61415 3Avon

61525 2Dunlap

61568 2Tremont

61603 2Peoria

61483 2Toulon

61616 2Peoria Heights

61565 2Sparland

61462 2Monmouth

61350 2Ottawa

61605 2Peoria

61536 1Hanna City

61570 1Washburn



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Central Illinois Endoscopy Center LLC PeoriaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 4,684

0145

2,8151,775

607

5,342

0298

5,4583,2101,060

10,026




TOTAL 4,684

1252,174

502,977

124

5,342

2204,198

1155,455

2711

10,026




127,5502,378,010 106,925 6,398,740 53,325 9,064,550

1.4%26.2% 1.2% 70.6% 0.6%


52,500

Charity Care

Expense

1%



Reference Numbers

002

7003155

143

Central Illinois Endoscopy Center LLC

1001 Main St., Suite 500B

Peoria, IL 61606

Administrator

Andy Paulson


Registered Agent

John Elias

Property Owner

GI Realty LLC

Legal Owner(s)

Facility Id



Andy Paulson 309-495-1184

Number of Operating Rooms


Number of Recovery Stations Stage 2

Exam Rooms 5

Procedure Rooms 3



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Unity Point - Methodist Medical Center of IL 6




Exam Rooms 5

Procedure Rooms 3

IGI Enterprises LLC

Methodist Medical Center

of 292 2/7/2020


Central Illinois Endoscopy Center LLC PeoriaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

61554 Tazewell 1035Pekin

61611 Tazewell 780East Peoria

61614 Peoria 765Peoria


61571 Tazewell 690Washington

61550 Tazewell 570Morton


61548 Woodford 440Metamora

61607 Peoria 355Bartonville

61523 Peoria 345Chillicothe

61525 Peoria 322Dunlap



61520 Fulton 181Canton

61559 Stark 125Princeville

61547 Peoria 122Mapleton

61517 Peoria 117Brimfield

61528 Peoria 115Edwards

61568 Tazewell 113Tremont


61536 Peoria 107Hanna City

61755 Tazewell 103Mackinaw

61540 Marshall 97Lacon

61616 Peoria 97Peoria Heights



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Peoria Ambulatory Surgery Center PeoriaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,940

12343583358453

1,749

25540

1,001899

1,224

3,689




TOTAL 1,940

42785

2692228

0

1,749

592,015

31,347

2650

3,689




42,797952,100 6,023 2,923,007 1,023,446 4,947,373

0.9%19.2% 0.1% 59.1% 20.7%


0

Charity Care

Expense

0%



Reference Numbers

002

7001530

143

Peoria Ambulatory Surgery Center

4909 N. Glen Park Place

Peoria, IL 61614

Administrator

Cynthia J. Leisinger, MBA


Registered Agent

Carl W. Soderstrom, MD

Property Owner

STORE Capital Corp.

Legal Owner(s)

Facility Id



Cynthia Leisinger 309-690-6012




Exam Rooms 0

Procedure Rooms 3



TOTAL 17.00

STAFFING PATTERNS



Type of Ownership




Methodist Unity Point, Peoria, IL 2




Exam Rooms 0

Procedure Rooms 3

Carl W. Soderstrom, MD

of 292 2/7/2020


Peoria Ambulatory Surgery Center PeoriaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


394.00 111.00TOTAL 190 505.00 2.66

61554 304Pekin

61550 171Morton

61614 167Peoria

61401 162Galesburg

61611 143East Peoria

61571 124Washington

61615 116Peoria

61356 87Princeton

61604 82Peoria

61607 78Bartonville

61443 75Kewanee

61354 63Peru

61520 60Canton

61350 59Ottawa

61761 59Normal

61525 58Dunlap

61548 55Metamora

61342 44Mendota

61523 44Chillicothe

61364 42Streator

61462 42Monmouth

61704 41Bloomington

61301 41La Salle

52732 38



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE


Dermatology 335 123 112 0.70235


Laser Eye 0 0 0 0.0000

of 292 2/7/2020


Peoria Day Surgery Center PeoriaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 769

83144146175100

648

177229321419271

1,417




TOTAL 769

1441620

157410

648

351,114

32189

470

1,417




9,517312,635 9,630 894,364 41,146 1,267,292

0.8%24.7% 0.8% 70.6% 3.2%


0

Charity Care

Expense

0%



Reference Numbers

002

7001449

143

Peoria Day Surgery Center

7309 North Knoxville

Peoria, IL 61614

Administrator

Dr. Justin Ahlman


Registered Agent

William Covey

Property Owner

Peoria Urological

Legal Owner(s)

Facility Id



Pam Cunningham 309-692-9210




Exam Rooms 0

Procedure Rooms 1



TOTAL 15.00

STAFFING PATTERNS



Type of Ownership

Sole Proprietorship



Unity Point Proctor 6




Exam Rooms 0

Procedure Rooms 1

Anthony Deceanne, D.P.M

Brent Parry, M.D.

Chittaranjan Reddy, M.D.

Christopher Lansford, M.D.

Curtis Ward, D.P.M.

Demaceo Howard, M.D.

Fred Braastad, M.D.

Gavish Patel, M.D.

Giovanni Colombo, M.D.

Harrison Putman, M.D

Ira Uretzky, M.D.

Jacek Graczykowski, M.D.

James Geraghty, M.D.

James Klemens, M.D.

John Mueller, M.D.

John Richier, M.D.

John Ruff, M.D.

Joseph Banno, M.D.

Joshua Croland, M.D.

Justin Ahlman, M.D.

Keith Ifft, M.D.

Kevin Brattain, D.P.M

Larry Overcash, M.D.

of 292 2/7/2020


Peoria Day Surgery Center PeoriaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


928.50 710.30TOTAL 1390 1638.80 1.18

61554 Tazewell 112Pekin

61571 Knox 107Washington


61611 Peoria 92East Peoria



61548 Tazewell 54Metamora

61550 Fulton 50Morton

61607 Tazewell 44Bartonville

61525 Peoria 44Dunlap

61523 Peoria 41Chillicothe

61443 Henry 33Kewanee

61520 Peoria 31Canton



61616 Peoria 23Peoria Heights

61562 Fulton 21Rome

61528 Peoria 19Edwards

61517 Peoria 18Brimfield

61559 Putnam 18Princeville

61610 Tazewell 17Peoria

61564 Tazewell 16South Pekin

61547 Woodford 16Mapleton

61540 Fulton 15Lacon



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000

Pain Management 47 7.02 7.84 0.3214.861

of 292 2/7/2020


Renal Intervention Center, L.L.C. MortonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 870

070

186169186

611

0173523388397

1,481




TOTAL 870

38508

06410

611

1191,233

7116

60

1,481




96,8831,788,971 7,819 446,315 23,626 2,363,614

4.1%75.7% 0.3% 18.9% 1.0%


0

Charity Care

Expense

0%



Reference Numbers

002

7002728

179

Renal Intervention Center, L.L.C.

430 Maxine Drive

Morton, IL 61550

Administrator

Beth Shaw


Registered Agent

Quinn, Johnston, Henderson, Pr

Property Owner

Dave Goewertzer

Legal Owner(s)

Facility Id



Annette Wounded Arrow 309-624-8321




Exam Rooms 1

Procedure Rooms 0


Director of NursesRegistered Nurses 5.50Certified AidesOther Health Profs. 3.50Other Non-Health Profs

TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




OSF St. Francis Medical Center, Peoria 5Unity Point Health Methodist, Peoria 0




Exam Rooms 1

Procedure Rooms 0

Heartland Home Health, Inc

OSF St. Francis, Inc

RenalCare Associates

of 292 2/7/2020


Renal Intervention Center, L.L.C. MortonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


799.74 556.86TOTAL 1481 1356.60 0.92

61604 PEORIA 83Peoria

61701 MCLEAN 75Bloomington




61554 TAZEWELL 58Pekin

61571 TAZEWELL 54Washington

61401 KNOX 51Galesburg

61761 MCLEAN 46Normal

61364 LA SALLE 45Streator

61611 TAZEWELL 44East Peoria

61443 HENRY 42Kewanee



61520 FULTON 30Canton

61201 ROCK ISLAND 25Rock Island

61550 TAZEWELL 20Morton

61607 PEORIA 20Bartonville

61455 MCDONOUGH 18Macomb

61265 ROCK ISLAND 16Moline

61350 LA SALLE 15Ottawa

61764 LIVINGSTON 14Pontiac

61738 WOODFORD 14El Paso

61570 MARSHALL 14Washburn



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Blessing Hospital ASTC QuincyAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 4,409

159805

2,2531,690

892

5,799

3251,2644,0742,8921,653

10,208




TOTAL 4,409

5892,760

372,365

2919

5,799

9504,787

884,280

5548

10,208




1,024,9725,955,104 140,240 17,155,990 135,213 24,411,518

4.2%24.4% 0.6% 70.3% 0.6%


62,917

Charity Care

Expense

0%



Reference Numbers

003

7003120

001

Blessing Hospital ASTC

1118 Hampshire Street

Quincy, IL 62301

Administrator

Maureen Kahn


Registered Agent

Property Owner

Quincy Medical Group

Legal Owner(s)

Facility Id



Ken Stegeman 217 223-8400




Exam Rooms 0

Procedure Rooms 3



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Blessing Hospital, Quincy, IL 12




Exam Rooms 0

Procedure Rooms 3

Blessing Hospital

of 292 2/7/2020


Blessing Hospital ASTC QuincyAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,892.00 1,752.00TOTAL 5250 4644.00 0.88

62301 ADAMS 2669Quincy

62305 ADAMS 1916Quincy

63401 Marion 374

62363 PIKE 259Pittsfield

63461 Marion 208

62347 ADAMS 205Liberty

63435 Lewis 202

62353 BROWN 184Mount Sterling

62351 ADAMS 183Mendon

62320 ADAMS 171Camp Point

62312 PIKE 160Barry

63445 Clark 155

62338 ADAMS 153Fowler

52632 LEE 153

62341 HANCOCK 130Hamilton

62360 ADAMS 129Payson

63448 Lewis 120

62321 HANCOCK 116Carthage

62681 SCHUYLER 112Rushville

62379 HANCOCK 107Warsaw

63456 Monroe 107

62376 ADAMS 94Ursa

61455 MCDONOUGH 92Macomb

63440 Lewis 91



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


HSHS St. John's Surgery Suites Montvale SpringfieldAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 876

029

324558327

1,238

042

526961585

2,114




TOTAL 876

5886313

29950

1,238

931,473

54489

50

2,114




119,8762,269,793 93,396 1,656,905 14,334 4,154,305

2.9%54.6% 2.2% 39.9% 0.3%


4,943

Charity Care

Expense

0%



Reference Numbers

003

7003187

167

HSHS St. John's Surgery Suites Montvale

2020 West Iles Avenue

Springfield, IL 62704

Administrator

EJ Kuiper, MHA,DPT,FACHE


Registered Agent

Michelle P. Clatfelter

Property Owner

Kane-Yeh Family LP

Legal Owner(s)

Facility Id



Sarah Hilligoss, RN,BSN 217-814-8060




Exam Rooms 2

Procedure Rooms 1



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




HSHS St. John's Hospital 1




Exam Rooms 2

Procedure Rooms 1

HSHS St. John's Hospital

of 292 2/7/2020


HSHS St. John's Surgery Suites Montvale SpringfieldAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


656.00 276.00TOTAL 1378 932.00 0.68

62704 Sangamon 295Springfield




62650 Morgan 99Jacksonville

62629 Sangamon 72Chatham


62656 Logan 61Lincoln


62690 Macoupin 42Virden

62640 Macoupin 41Girard

62684 Sangamon 36Sherman

62563 Sangamon 33Rochester

62615 Sangamon 32Auburn

62568 Christian 27Taylorville

62613 Menard 24Athens

62561 Sangamon 24Riverton

62612 Cass 23Ashland

62677 Sangamon 19Pleasant Plains

62521 Macon 17Decatur

62548 Logan 16Mount Pulaski

62618 Cass 16Beardstown

62638 Morgan 14Franklin

62049 Montgomery 14Hillsboro



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 736 420 100 0.715201


of 292 2/7/2020


Orthopaedic Surgery Center of Illinois SpringfieldAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,643

1155535562642

1,895

2354

1,0211,0201,141

3,538




TOTAL 1,643

01,171

281440

30

1,895

02,057

514959

80

3,538




31,4251,481,091 0 3,923,128 51,386 5,487,030

0.6%27.0% 0.0% 71.5% 0.9%


0

Charity Care

Expense

0%



Reference Numbers

003

7002306

167

Orthopaedic Surgery Center of Illinois

3136 Old Jacksonville Road, Ste 250


Administrator

Christopher W. Maender M.D.


Registered Agent

Robert Kay / Katie Kiem

Property Owner

MHS

Legal Owner(s)

Facility Id



Kim Schultz 217-862-0500




Exam Rooms 1

Procedure Rooms 0



TOTAL 17.70

STAFFING PATTERNS



Type of Ownership




Memorial Medical Center 1




Exam Rooms 1

Procedure Rooms 0

MEM HEALTH VENTURE

ORTO, LLC

of 292 2/7/2020


Orthopaedic Surgery Center of Illinois SpringfieldAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.000 0.00 0.00General 0.00 0.000 0.00 0.00Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 0.00 0.000 0.00 0.00Ophthalmology 167.25 171.75478 339.00 0.71Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 1,045.50 432.00864 1477.50 1.71Otolaryngology 0.00 0.000 0.00 0.00Pain Management 263.50 329.502196 593.00 0.27Plastic Surgery 0.00 0.000 0.00 0.00Podiatry 0.00 0.000 0.00 0.00Thoracic 0.00 0.000 0.00 0.00Urology 0.00 0.000 0.00 0.00

1,476.25 933.25TOTAL 3538 2409.50 0.68





62650 Morgan 150Jacksonville

62629 Sangamon 126Chatham

62656 Logan 120Lincoln



62675 Menard 84Petersburg

62568 Christian 77Taylorville

62684 Sangamon 60Sherman

62640 Macoupin 56Girard

62615 Sangamon 53Auburn

62670 Sangamon 52New Berlin

62558 Sangamon 51Pawnee

62690 Macoupin 46Virden

62561 Sangamon 43Riverton

62644 Mason 41Havana

62056 Montgomery 40Litchfield

62563 Sangamon 38Rochester

62626 Macoupin 33Carlinville

62613 Menard 32Athens

62618 Cass 29Beardstown



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Springfield Clinic, LLP SpringfieldAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018

0-14 years 27215-44 years 1,33545-64 years 4,60365-74 years 2,98775+ years 1,875

TOTAL 11,072

2331,7915,4803,5712,106

13,181

5053,126

10,0836,5583,981

24,253




TOTAL 11,072

185,671

07,388

1040

13,181

3210,325

013,705

1910

24,253




018,490,513 0 25,397,176 445,895 44,333,584

0.0%41.7% 0.0% 57.3% 1.0%


0

Charity Care

Expense

0%



Reference Numbers

003

7002694

167

Springfield Clinic, LLP

1025 South 6th Street


Administrator

Ray Williams


Registered Agent

Ray Williams

Property Owner

Legal Owner(s)

Facility Id



Jennifer Boyer 217-528-7541




Exam Rooms 16

Procedure Rooms 7



TOTAL 136.81

STAFFING PATTERNS



Type of Ownership

Limited Partnership (RA required)



St. John's Hospital, Springfield 1Memorial Medical Center, Springfield 10




Exam Rooms 16

Procedure Rooms 7

Abraham, Arun

Abraham, P. James

Acakpo-Satchivi, Leslie

Adaramola, Akindele

Albracht, Bryan J.

Albright, Deborah

Allen, Stanley E

Annaba, Fadi

Aw, Diane

Barkmeier, Lynne

Beal, Heather

Becker, Cecile

Bennett, Tara Z

Benning, Lisa A

Bergman, Beth A.

Beyer, Vivianne

Bhandari, Purvi

Bhandari, Ramanath

Bilyeu, Alan

Bilyeu, Alison

Bilyeu,Thomas

Bland, Geoffrey A.

Borowiecki, Thomasz W.

of 292 2/7/2020


Springfield Clinic, LLP SpringfieldAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 83.95 77.35222 161.30 0.73General 634.90 418.25998 1053.15 1.06Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 10.98 4.358 15.33 1.92OB/Gynecology 158.10 138.05369 296.15 0.80Ophthalmology 615.38 339.251538 954.63 0.62Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 1,578.80 938.322414 2517.12 1.04Otolaryngology 395.28 206.10757 601.38 0.79Pain Management 0.00 0.000 0.00 0.00Plastic Surgery 1,294.44 480.401673 1774.84 1.06Podiatry 226.45 47.40243 273.85 1.13Thoracic 0.00 0.000 0.00 0.00Urology 194.77 196.71697 391.48 0.56

5,193.05 2,846.18TOTAL 8919 8039.23 0.90

62858 Clay 5Louisville

62544 Macon 5Macon

61705 McLean 5Bloomington

61873 Champaign 5Saint Joseph

62541 Logan 5Lake Fork

62035 Madison 5Godfrey

62058 Madison 4Livingston

61832 Vermilion 4Danville

62361 Pike 4Pearl

62076 Montgomery 4Ohlman

61401 Knox 4Galesburg

61856 Piatt 4Monticello

62275 Bond 4Pocahontas

63118 St. Louis 4

62063 Macoupin 4Medora

62011 Fayette 4Bingham

61420 McDonough 4Blandinsville

62440 Coles 4Lerna

61452 Schuyler 4Littleton

62411 Effingham 4Altamont

62534 Shelby 4Findlay

62025 Madison 4Edwardsville

61756 Macon 4Maroa

62321 Hancock 4Carthage



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000

Pain Management 3030 430.3 303.35 0.24733.652

of 292 2/7/2020


Bloomington Eye Institute, LLC BloomingtonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,711

019

531917652

2,119

147

9571,6011,224

3,830




TOTAL 1,711

81,489

5608

45

2,119

162,627

1081,055

159

3,830




7,3742,574,263 10,722 1,372,589 1,019,260 4,984,208

0.1%51.6% 0.2% 27.5% 20.4%


34,543

Charity Care

Expense

1%



Reference Numbers

004

7002249

113

Bloomington Eye Institute, LLC

1008 North Center St

Bloomington, IL 61701

Administrator

Tom Restivo


Registered Agent

William Mueller/ Mueller and

Property Owner

Gailey Eye Institute Prop

Legal Owner(s)

Facility Id



Karen Magers, RN 309-827-2020




Exam Rooms 0

Procedure Rooms 0



TOTAL 23.30

STAFFING PATTERNS



Type of Ownership




Advocate BroMenn Medical Center, Bloomington 1OSF St Joseph's Medical Center, Bloomington 1




Exam Rooms 0

Procedure Rooms 0

Ara Aprahamian, MD

Gregory Halperin, MD

Joseph Harman, MD

Ken Barba, MD

Robert Lee, MD

Sumit Bhatia, MD

of 292 2/7/2020


Bloomington Eye Institute, LLC BloomingtonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


619.50 654.25TOTAL 3830 1273.75 0.33




62521 MACON 120Decatur



61727 DEWITT 80Clinton


60936 LASALLE 66Gibson City

61554 TAZEWELL 65Pekin

61832 VERMILION 58Danville

62656 LOGAN 57Lincoln

61350 LASALLE 54Ottawa

61739 LIVINGSTON 52Fairbury

61745 MCLEAN 45Heyworth

61301 LASALLE 38La Salle


61362 BUREAU 34Spring Valley

61330 34La Moille

61760 WOODFORD 33Minonk

62535 MACON 32Forsyth

61364 LASALLE 32Streator


61748 MCLEAN 29Hudson



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Bloomington Normal Healthcare Surgery Center, L NormalAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,041

1438050317490

1,161

59562961394226

2,202




TOTAL 1,041

124301

0722140

1,161

216649

01,311

260

2,202




1,150,5204,313,639 0 9,459,977 148,602 15,072,738

7.6%28.6% 0.0% 62.8% 1.0%


0

Charity Care

Expense

0%



Reference Numbers

004

7002512

113

Bloomington Normal Healthcare Surgery Center, LLC

2100 Fort Jesse Road

Normal, IL 61761

Administrator

Brenda Cyrulik


Registered Agent

Sarah Chacko

Property Owner

Legal Owner(s)

Facility Id



Brenda L McKee 309-834-4000




Exam Rooms 0

Procedure Rooms 0



TOTAL 19.00

STAFFING PATTERNS



Type of Ownership




St. Joseph Medical Center Bloomington 2Advocate BroMenn Regional Medical Center Normal 2




Exam Rooms 0

Procedure Rooms 0

Benjamin Leak

Brett Keller

Catherine Crockett

Daniel Brownstone

Daniel Nord

David Naour

Gerardo Grieco

Jeff Poulter

John Wieland

Joseph Newcomer

Katherine Widerborg

Marc Leonard

Mariano Tolentino

Omar Khokhar

Paige Holt

Scott Morgan

Scott O’Connor

Scott Pinter

St Joseph Medical Center

Stephen Matter

Susan Svientek

Todd Snoeyink

Travis Holt

of 292 2/7/2020


Bloomington Normal Healthcare Surgery Center, L NormalAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,043.00 1,543.50TOTAL 2202 2586.50 1.17

61761 368Normal

61704 355Bloomington



61764 89Pontiac

61727 66Clinton

61745 46Heyworth

61752 45Le Roy

61738 45El Paso

61748 45Hudson

61739 33Fairbury

61364 32Streator

61726 31Chenoa

61732 26Danvers

61554 24Pekin

61753 23Lexington

61728 22Colfax

61744 21Gridley

61754 21Mc Lean

61736 19Downs

61725 18Carlock

61776 17Towanda

61530 15Eureka

61755 15Mackinaw



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Carle SurgiCenter DanvilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 680

21191463216134

1,025

56257779387226

1,705




TOTAL 680

223342

5361

193

1,025

339589

8614

2153

1,705




185,047526,896 5,139 2,095,593 0 2,812,675

6.6%18.7% 0.2% 74.5% 0.0%


57,884

Charity Care

Expense

2%



Reference Numbers

004

7002439

183

Carle SurgiCenter

2300 N. Vermilion

Danville, IL 61832

Administrator

Kerry Fox


Registered Agent

Property Owner

Legal Owner(s)

Facility Id



Collin Anderson 217-902-5521




Exam Rooms 0

Procedure Rooms 1



TOTAL 16.05

STAFFING PATTERNS



Type of Ownership




The Carle Foundation Hospital (Urbana) 2OSF Sacred Heart Medical Center (Danville) 0




Exam Rooms 0

Procedure Rooms 1

Carle Foundation Hospital

of 292 2/7/2020


Carle SurgiCenter DanvilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


516.00 122.00TOTAL 609 638.00 1.05

61832 781Danville

61834 179Danville

61883 104Westville

61846 94Georgetown

60942 66Hoopeston

61858 63Oakwood

61833 53Danville

61817 50Catlin

47932 47

60963 42Rossville

61841 21Fairmount

61814 19Bismarck

61870 17Ridge Farm

61850 12Indianola

61924 12Chrisman

61876 9Sidell

61865 9Potomac

61811 9Alvin

61844 8Fithian

47993 8

61848 8Henning

47991 7

47928 7

61944 7Paris



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Champaign SurgiCenter, LLC ChampaignAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,348

330982

1,103387186

2,988

7411,6871,874

689345

5,336




TOTAL 2,348

51453524

1,55922

334

2,988

890949

482,853

32564

5,336




568,8571,284,383 62,860 15,606,541 53,359 17,576,000

3.2%7.3% 0.4% 88.8% 0.3%


357,875

Charity Care

Expense

2%



Reference Numbers

004

7002959

019

Champaign SurgiCenter, LLC

3103 Fields South Dr.

Champaign, IL 61822

Administrator

Kerry Fox


Registered Agent

James Leonard, MD

Property Owner

Legal Owner(s)

Facility Id



Collin Anderson 217-902-5521




Exam Rooms 0

Procedure Rooms 0



TOTAL

STAFFING PATTERNS



Type of Ownership




Carle Foundation Hospital (Urbana) 10OSF Heart of Mary Medical Center (Urbana) 0




Exam Rooms 0

Procedure Rooms 0

Carle Health Care Inc.

Christie Clinic ASC, LLC

of 292 2/7/2020


Champaign SurgiCenter, LLC ChampaignAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


5,516.00 1,066.00TOTAL 5336 6582.00 1.23

61821 459Champaign

61822 456Champaign

61802 308Urbana

61853 304Mahomet

61820 248Champaign

61832 248Danville

61801 236Urbana

61866 221Rantoul

61856 153Monticello

61873 146Saint Joseph

61874 140Savoy

61920 116Charleston

61938 106Mattoon

61880 102Tolono

60957 89Paxton

61953 80Tuscola

61834 73Danville

61956 62Villa Grove

61846 57Georgetown

61883 51Westville

60942 45Hoopeston

61843 43Fisher

61849 40Homer

61944 39Paris



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Digestive Disease Endoscopy Center NormalAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018

0-14 years 015-44 years 28345-64 years 1,09465-74 years 51975+ years 162

TOTAL 2,058

1448

1,473634192

2,748

1731

2,5671,153

354

4,806




TOTAL 2,058

14702

52,020

61

2,748

171,290

113,472

142

4,806




5,406628,491 12,291 4,321,731 24,750 4,992,669

0.1%12.6% 0.2% 86.6% 0.5%


4,600

Charity Care

Expense

0%



Reference Numbers

004

7002710

113

Digestive Disease Endoscopy Center

1302 Franklin Avenue Suite 1000

Normal, IL 61761

Administrator

Cynthia Durham


Registered Agent

Scott Becker

Property Owner

Advocate Health & Hosp

Legal Owner(s)

Facility Id



Cynthia Durham 309-268-3400




Exam Rooms 1

Procedure Rooms 3



TOTAL 17.55

STAFFING PATTERNS



Type of Ownership




Advocate BroMenn Medical Center- Normal 5




Exam Rooms 1

Procedure Rooms 3

BroMenn Physicians Mana

Darryl Fernandes, MD

Kenneth Schoenig, MD

Philip Koszyk, MD

Physicians Endoscopy

Thomas DeWeert, MD

Vijay Laxmi Misra, MD

of 292 2/7/2020


Digestive Disease Endoscopy Center NormalAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00


61761 961Normal



61752 120Le Roy

61738 108El Paso

61748 105Hudson

61753 105Lexington

61745 104Heyworth

61727 94Clinton

61739 89Fairbury

61764 74Pontiac

61776 65Towanda

61736 61Downs

61726 54Chenoa

61744 51Gridley

61725 49Carlock

61732 43Danvers

61723 43Atlanta

61754 33Mc Lean

61760 32Minonk

61728 32Colfax

61530 24Eureka

61755 23Mackinaw



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE


Gastro-Intestinal 4806 2484.25 1602 0.854086.253

Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Eastland Medical Plaza Surgicenter BloomingtonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 3,362

33810

1,7171,087

683

4,330

721,3243,1191,9361,241

7,692




TOTAL 3,362

3721,554

852,256

630

4,330

5712,688

1434,202

880

7,692




2,572,99514,031,003 25,180 18,969,903 315,759 35,914,840

7.2%39.1% 0.1% 52.8% 0.9%


42,978

Charity Care

Expense

0%



Reference Numbers

004

7002413

113

Eastland Medical Plaza Surgicenter

1505 Eastland Drive


Administrator

Brenda Cyrulik


Registered Agent

Brenda Cyrulik

Property Owner

OSF ST JOSEPH

Legal Owner(s)

Facility Id



Jackie Frye 309-661-5004




Exam Rooms 5

Procedure Rooms 5


Director of NursesRegistered Nurses 30.00Certified Aides 1.00Other Health Profs. 11.00Other Non-Health Profs 6.00

TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




OSF St Joseph Medical Center, Bloomington 18




Exam Rooms 5

Procedure Rooms 5

of 292 2/7/2020


Eastland Medical Plaza Surgicenter BloomingtonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,518.50 867.60TOTAL 4338 2386.10 0.55

MCLEAN 5453

LIVINGSTON 840

DEWITT 414

WOODFORD 272

TAZEWELL 133

LASALLE 112

LOGAN 96

CHAMPAIGN 90

FORD 30

PEORA 29

MARSHALL 25

MACON 24

ADAMS 22

PIATT 20

SANGAMON 16

DOUGLAS 11

COOK 9

GRUNDY 8

IROGUOIS 7

VERMILLION 6

COLES 5

HANCOCK 4

SHELBY 4

STARK 4



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE


Gastro-Intestinal 2831 844 566.2 0.501410.24

Laser Eye 523 270 104.6 0.72374.61


of 292 2/7/2020


Gailey Eye Surgery-Decatur, LLC DecaturAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 655

03

176384283

846

08

280665548

1,501




TOTAL 655

14679

6145

20

846

171,150

94238

20

1,501




17,6791,023,401 91,577 754,467 7,241 1,894,365

0.9%54.0% 4.8% 39.8% 0.4%


0

Charity Care

Expense

0%



Reference Numbers

004

7003170

115

Gailey Eye Surgery-Decatur, LLC

646 W. Pershing Rd.

Decatur, IL 62526

Administrator

Tom Restivo


Registered Agent

Laurence A. Hansen

Property Owner

G Prop, LLC

Legal Owner(s)

Facility Id



Jody Cramer, RN 217-875-2600




Exam Rooms 0

Procedure Rooms 0



TOTAL 8.75

STAFFING PATTERNS



Type of Ownership




Decatur Memorial Hospital, Decatur 3




Exam Rooms 0

Procedure Rooms 0

Ara Aprahamian, MD

Gregory Halperin, MD

Joseph Harman, MD

Kenneth Barba, MD

Robert Lee MD

Sumit Bhatia, MD

of 292 2/7/2020


Gailey Eye Surgery-Decatur, LLC DecaturAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


125.00 237.75TOTAL 1501 362.75 0.24

62521 352Decatur

62526 292Decatur

62522 145Decatur

61727 45Clinton

62535 43Forsyth

62565 43Shelbyville

62549 40Mount Zion

62550 33Moweaqua

62501 27Argenta

61951 26Sullivan

62544 24Macon

62573 23Warrensburg

62548 21Mount Pulaski

62702 19Springfield

62557 18Pana

61818 18Cerro Gordo

61914 16Bethany

61813 12Bement

61856 12Monticello

62513 11Blue Mound

62568 11Taylorville

61701 11Bloomington

62510 10Assumption

61756 10Maroa



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Gastrointestinal Institute, LLC NormalAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 956

2021960362235

1,499

29359989

1,02157

2,455




TOTAL 1,024

227435112634149

1,431

371827184

1,0382213

2,455




9,907406,097 93,092 1,336,028 10,020 1,855,144

0.5%21.9% 5.0% 72.0% 0.5%


23,822

Charity Care

Expense

1%



Reference Numbers

004

7003056

113

Gastrointestinal Institute, LLC

2200 Jacobssen Drive Ste. A

Normal, IL 61761

Administrator

Phil McGowan


Registered Agent

Stephen S. Matter, MD

Property Owner

Halstead Dr., LLC

Legal Owner(s)

Facility Id



Phil McGowan 309-451-1123




Exam Rooms 8

Procedure Rooms 2



TOTAL 14.00

STAFFING PATTERNS



Type of Ownership

Sole Proprietorship



OSF St. Joseph Medical Center 1




Exam Rooms 8

Procedure Rooms 2

Stephen S. Matter, MD

of 292 2/7/2020


Gastrointestinal Institute, LLC NormalAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


818.33 613.66TOTAL 2455 1431.99 0.58



61764 292Pontiac


61727 107Clinton

61726 84Chenoa

61738 80El Paso

61364 75Streator

61739 63Fairbury

60921 31Chatsworth

60420 28Dwight

61732 27Danvers

60460 26Odell

61776 23Towanda

61736 23Downs

61725 19Carlock

61728 16Colfax

61774 15Stanford

61377 14Wenona

60929 13Cullom

61737 12Ellsworth

61771 12Secor

61350 11Ottawa

61530 10Eureka



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Ireland Grove Center for Surgery BloomingtonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,057

185313575187124

1,384

413563979308178

2,441




TOTAL 1,057

9291

51,069

100

1,384

21436

71,961

160

2,441




106,8704,051,141 42,499 17,924,389 124,063 22,248,963

0.5%18.2% 0.2% 80.6% 0.6%


0

Charity Care

Expense

0%



Reference Numbers

004

7003129

113

Ireland Grove Center for Surgery

3801 Ireland Grove Rd


Administrator

Stacey Olsen


Registered Agent

William Kindorf III

Property Owner

Legal Owner(s)

Facility Id



Stacey Olsen 309-664-0101




Exam Rooms 0

Procedure Rooms 0



TOTAL 16.50

STAFFING PATTERNS



Type of Ownership




Advocate BroMenn Medical Center, Normal 1OSF St Joseph Medical Center, Bloomington 1




Exam Rooms 0

Procedure Rooms 0

Chad Tattini MD

Dennis Lee MD

Edward Kolb MD

Gerardo Grieco MD

Ji Li MD

Lawrence Li MD

Robert Russell MD

of 292 2/7/2020


Ireland Grove Center for Surgery BloomingtonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,043.25 773.32TOTAL 2441 1816.57 0.74






61745 MCLEAN 69Heyworth

61752 McLean 52Le Roy

61727 DEWITT 51Clinton


61364 LA SALLE 46Streator

61744 MCLEAN 41Gridley

61732 MCLEAN 37Danvers

61748 MCLEAN 33Hudson

61753 MCLEAN 28Lexington

61736 MCLEAN 28Downs

61740 LIVINGSTON 28Flanagan

62656 LOGAN 22Lincoln

61726 MCLEAN 22Chenoa

61739 LIVINGSTON 21Fairbury

61755 TAZEWELL 19Mackinaw

61728 MCLEAN 19Colfax

61777 DEWITT 18Wapella

60420 LIVINGSTON 17Dwight

61774 MCLEAN 16Stanford



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Olympian Surgical Suites LLC Champaign AMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 33

0938740

184

0108105

40

217




TOTAL 33

120

124570

184

120

152620

217




0709 0 1,369,306 386,953 1,756,968

0.0%0.0% 0.0% 77.9% 22.0%


0

Charity Care

Expense

0%



Reference Numbers

004

7003145

019

Olympian Surgical Suites LLC

1002 Interstate Dr

Champaign , IL 61822

Administrator

Julie Root


Registered Agent

Donald Gordon

Property Owner

R & B Champaign

Legal Owner(s)

Facility Id



Julie Root 217-693-5700




Exam Rooms 0

Procedure Rooms 0


Director of Nurses 1.00Registered Nurses 0.25Certified AidesOther Health Profs. 0.25Other Non-Health Profs

TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




OSF Heart of Mary, Urbana IL 1




Exam Rooms 0

Procedure Rooms 0

Donald Gordon

Julie Root

Sidney Rohrscheib

of 292 2/7/2020


Olympian Surgical Suites LLC Champaign AMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


223.48 65.80TOTAL 217 289.28 1.33

62521 10Decatur

61822 9Champaign

62526 7Decatur

61920 6Charleston

61802 6Urbana

61853 6Mahomet

61821 5Champaign

61761 5Normal

61704 4Bloomington

62401 4Effingham

62549 4Mount Zion

62864 4Mount Vernon

61938 4Mattoon

61873 4Saint Joseph

62522 4Decatur

61701 4Bloomington

61727 4Clinton

61944 4Paris

62656 3Lincoln

61550 2Morton

62837 2Fairfield

61856 2Monticello

61914 2Bethany

61832 2Danville



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


The Center for Orthopedic Medicine BloomingtonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,624

201630

1,403567540

3,341

4371,2332,4521,013

830

5,965




TOTAL 2,624

167851

82,220

932

3,341

4171,610

123,753

1676

5,965




254,0991,328,489 5,341 10,760,660 208,294 12,556,883

2.0%10.6% 0.0% 85.7% 1.7%


6,400

Charity Care

Expense

0%



Reference Numbers

004

7002116

113

The Center for Orthopedic Medicine

2502 B East Empire Street


Administrator

Bryan Zowin


Registered Agent

Sarah E Gardner

Property Owner

Stage Equity Partners

Legal Owner(s)

Facility Id



Sarah Gardner 309-662-6120




Exam Rooms 0

Procedure Rooms 1



TOTAL 56.00

STAFFING PATTERNS



Type of Ownership




Advocate BroMenn Medical Center 6




Exam Rooms 0

Procedure Rooms 1

Brian Hamm, DPM

BroMenn Phys Mgmt Corp

Bryce Paschold, DPM

Carle Foundation

Craig Carmichael, MD

Gerald Paul, DPM

Gregory Deitz, DMD

Jason Seibly, DO

Jerome Oakley, MD

Joseph Norris, MD

Joseph Novotny, MD

Laura Randolph, MD

Mark Hanson, MD

McLean County SurgiCent

Nikhil Chokshi, MD

Robert Seidl, MD

Sherri Thornton, MD

Thomas Kelly, MD

Willard Noyes, MD

of 292 2/7/2020


The Center for Orthopedic Medicine BloomingtonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


3,588.85 4,019.50TOTAL 3597 7608.35 2.12

61761 980Normal




61764 156Pontiac

61752 151Le Roy

61748 134Hudson

61745 121Heyworth

61753 120Lexington

61738 117El Paso

61727 110Clinton

61739 104Fairbury

61726 85Chenoa

61364 69Streator

61728 68Colfax

61776 64Towanda

61732 60Danvers

61744 56Gridley

61736 55Downs

61723 50Atlanta

61740 42Flanagan

61530 42Eureka

61725 40Carlock

62656 38Lincoln



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000

Pain Management 2368 897 1184 0.8820811

of 292 2/7/2020


The Danville Polyclinic, ASTC DanvilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,619

7275538323252

1,395

110403

1,082766653

3,014




TOTAL 1,619

209634

1544

70

1,395

3351,483

91,109

780

3,014




232,493923,547 5,817 1,159,708 232,507 2,554,071

9.1%36.2% 0.2% 45.4% 9.1%


0

Charity Care

Expense

0%



Reference Numbers

004

7002371

183

The Danville Polyclinic, ASTC

707 N. Logan Ave.

Danville, IL 61832

Administrator

Amy Stinespring


Registered Agent

Melissa Edington

Property Owner

Legal Owner(s)

Facility Id



Amy Stinespring 217-477-4794




Exam Rooms 1

Procedure Rooms 0



TOTAL 12.00

STAFFING PATTERNS



Type of Ownership




Sacred Heart Medical Center (OSF) Danville Illinoi 1




Exam Rooms 1

Procedure Rooms 0

Aaron C. Eubanks, MD

Bhaskar N. Patel, MD

Bikramjit Malhotra, MD

Harikrishna P. Patel, MD

Huan Jane Hsieh, MD

Kirk M. Bott, DPM

Mohannad Rajjoub, MD

Muhammad Mushtaq, MD

Naresh C. Goel, MD

Padmashree B. Reddy, MD

Raja Irfan Sadiq, MD

Sebastian J. Ciancio, MD

Uma Sekar, MD

Venkat E. Sekar, MD

William J. Bowen, MD

Zlatka Jeliazkova, MD

of 292 2/7/2020


The Danville Polyclinic, ASTC DanvilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,343.00 1,666.00TOTAL 3014 4009.00 1.33



61883 Vermilion 208Westville

61846 Vermilion 182Georgetown


47932 Fountain 114

61817 Vermilion 104Catlin

61858 Vermilion 98Oakwood

61870 Vermilion 63Ridge Farm

60963 Vermilion 58Rossville

60942 Vermilion 52Hoopeston

61814 Vermilion 50Bismarck

61841 Vermilion 46Fairmount

47993 Warren 36

47987 Fountain 27

61924 Edgar 26Chrisman

47928 Vermillion 26

61811 Vermilion 25Alvin

47974 Vermillion 21

47952 Fountain 18

61876 Vermilion 15Sidell

61850 Vermilion 15Indianola

61844 Vermilion 15Fithian

61865 Vermilion 13Potomac



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Effingham Ambulatory Surgery Center EffinghamAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,932

25481

1,216949772

3,443

67881

2,2451,7861,396

6,375




TOTAL 2,932

1351,797

181,480

103

3,443

1843,291

322,835

294

6,375




65,3212,469,354 30,242 10,571,434 68,409 13,204,760

0.5%18.7% 0.2% 80.1% 0.5%


20,043

Charity Care

Expense

0%



Reference Numbers

005

7003178

049

Effingham Ambulatory Surgery Center

904 W Temple

Effingham, IL 62401

Administrator

Same


Registered Agent

CT Corporation System

Property Owner

Effingham Medical Prop.

Legal Owner(s)

Facility Id



Jean Dunaway, RN, CASC 217-342-1234




Exam Rooms 0

Procedure Rooms 0



TOTAL 56.00

STAFFING PATTERNS



Type of Ownership




HSHS St. Anthony's Hospital Effingham, IL 7




Exam Rooms 0

Procedure Rooms 0

Brian Ogan, MD

Frank Lee, MD

James Flaig, DO

James Graham, DPM

Jason McAllaster

Jay Swanson, MD, DDS

Jeff Whightsel, MD

John Kay, MD

Joseph Spraul, MD

Kelly Haller, MD

Kevin Malone, MD

Lisa Kowalski, MD

Lisa Sasso, MD

Nash Naam, MD

Patrick Stewart, MD

Ruben Boyajian, MD

SBL Practice Aquisitions

USP Effingham, Inc

of 292 2/7/2020


Effingham Ambulatory Surgery Center EffinghamAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.001483 0.00 0.00General 1,177.60 2,655.67531 3833.27 7.22Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 152.75 253.18206 405.93 1.97Ophthalmology 449.35 1,050.12991 1499.47 1.51Oral/Maxillofacial 120.98 132.6886 253.66 2.95Orthopedic 1,079.23 1,756.071164 2835.30 2.44Otolaryngology 18.07 29.4742 47.54 1.13Pain Management 397.98 2,194.401830 2592.38 1.42Plastic Surgery 0.90 1.251 2.15 2.15Podiatry 33.42 54.7040 88.12 2.20Thoracic 0.00 0.000 0.00 0.00Urology 0.95 1.031 1.98 1.98

3,431.23 8,128.57TOTAL 6375 11559.80 1.81

62401 Effingham 1319Effingham

62448 Jasper 372Newton

62411 Effingham 262Altamont

62471 Fayette 233Vandalia

62450 Richland 215Saint Francisville

62450 Richland 215Olney

62839 Clay 186Flora

62467 Effingham 184Teutopolis

62858 Clay 163Louisville

61938 Coles 160Mattoon

62424 Effingham 155Dieterich

62458 Fayette 149Saint Elmo

62414 Effingham 144Beecher City

62447 Cumberland 130Neoga

61920 Coles 105Charleston

62443 Effingham 105Mason

62418 Fayette 96Brownstown

62463 Shelby 93Stewardson

62565 Shelby 89Shelbyville

62838 Fayette 87Farina

62473 Effingham 83Watson

62428 Cumberland 80Greenup

62462 Shelby 74Sigel

62454 Crawford 73Robinson



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Marion Eye Surgery Center, LLC. Mt VernonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,096

557

8421,089

498

2,491

12128

1,4701,985

992

4,587




TOTAL 2,096

3021,337

9820230

2,491

4922,283

2231,524

650

4,587




307,0192,370,500 171,200 2,885,073 66,208 5,800,000

5.3%40.9% 3.0% 49.7% 1.1%


0

Charity Care

Expense

0%



Reference Numbers

005

7003143

081

Marion Eye Surgery Center, LLC.

2900 Broadway, Suite B

Mt Vernon, IL 62864

Administrator

Marla Zinzilieta


Registered Agent

Maqbool Ahmad MD

Property Owner

Legal Owner(s)

Facility Id



Marla Zinzilieta 618-969-8700




Exam Rooms 1

Procedure Rooms 0



TOTAL 20.00

STAFFING PATTERNS



Type of Ownership




SSM Health-Good Samaritan Hospital 7




Exam Rooms 1

Procedure Rooms 0

Faisel Ahmad MD

George Ortiz MD

Maqbool Ahmad MD

Omar Ahmad MD

Ukeme Umana MD

of 292 2/7/2020


Marion Eye Surgery Center, LLC. Mt VernonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,744.05 1,529.00TOTAL 4587 3273.05 0.71

62959 Williamson 281Marion

62864 Jefferson 277Mount Vernon

62801 Marion 178Centralia

62901 Jackson 164Carbondale

62896 Franklin 159West Frankfort

62948 Williamson 145Herrin

62966 Jackson 144Murphysboro

62812 Franklin 143Benton

62832 Perry 121DuQuoin

62918 Williamson 115Carterville

62837 Wayne 103Fairfield

62839 Clay 87Flora

62951 Williamson 81Johnston City

62274 Perry 74Pinckneyville

62450 Richland 69Saint Francisville

62450 Richland 69Olney

62906 Union 68Anna

62939 Johnson 65Goreville

62946 Saline 60Harrisburg

62922 Williamson 57Creal Springs

62881 Marion 57Salem

62995 Johnson 51Vienna

62401 Effingham 50Effingham

62471 Fayette 49Vandalia



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Marion HealthCare LLC MarionAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,338

24257467620379

1,747

81400830

1,058716

3,085




TOTAL 1,338

33582320

56270

1,747

5301,347

231964

130

3,085




275,8431,017,252 139,626 1,591,843 278,114 3,302,678

8.4%30.8% 4.2% 48.2% 8.4%


0

Charity Care

Expense

0%



Reference Numbers

005

7002801

199

Marion HealthCare LLC

3003 Civic Circle Blvd

Marion, IL 62959

Administrator

Jennifer Van Meter


Registered Agent

Thomas J. Pliura, M.D., J.D.

Property Owner

Marion HealthCare Real

Legal Owner(s)

Facility Id



Scott Hendren 309-962-2299




Exam Rooms 0

Procedure Rooms 1



TOTAL 33.20

STAFFING PATTERNS



Type of Ownership




Heartland Regional, Marion, IL 4




Exam Rooms 0

Procedure Rooms 1

Alberto Cuartus, MD

Clay DeMattei, MD

David Mann, MD

Elisabeth Beyer Nolen, MD

Frank Bleyer, MD

Jeffery Deacon, DPM

Jodi Bryant, MD

KhaIid Javed, MD

Michael Schifano, DO

Patrick Sayavong, DO

R. Lawrence Hatchett, MD

Sean McCain, MD

SushilkumarTibrewala, MD

Suzanne Burge, MD

Thomas J. Pliura, MD

Udaya Liyanage, MD

of 292 2/7/2020


Marion HealthCare LLC MarionAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


972.00 1,023.50TOTAL 2576 1995.50 0.77

62959 794Marion

62948 268Herrin

62896 190West Frankfort

62918 161Carterville

62951 126Johnston City

62812 117Benton

62901 100Carbondale

62939 99Goreville

62922 86Creal Springs

62946 85Harrisburg

62966 56Murphysboro

62832 50DuQuoin

62995 46Vienna

62933 45Energy

62822 43Christopher

62890 42Thompsonville

62960 38Metropolis

62974 37Pittsburg

62884 36Sesser

62906 35Anna

62902 32Carbondale

62930 30Eldorado

62865 26Mulkeytown

62999 25Zeigler



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Massac County Surgery Center LLC MetropolisAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 733

1320239712545

782

3244773723069

1,515




TOTAL 733

10317010

49180

782

156293

171,032

170

1,515




221,5521,495,489 51,034 4,937,603 49,234 6,754,912

3.3%22.1% 0.8% 73.1% 0.7%


1,182

Charity Care

Expense

0%



Reference Numbers

005

7003200

127

Massac County Surgery Center LLC

1811 East 5th Street

Metropolis, IL 62960

Administrator

Greg Thomspson


Registered Agent

Greg Thompson

Property Owner

Legal Owner(s)

Facility Id



Melanie Russell 618-309-6005




Exam Rooms 1

Procedure Rooms 0



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Massac Memorial Hospital, Metropolis, Illinois 1




Exam Rooms 1

Procedure Rooms 0

Massac Memorial LLC

OIWK Holdings

of 292 2/7/2020


Massac County Surgery Center LLC MetropolisAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,353.00 1,002.75TOTAL 1516 2355.75 1.55

42003 McCracken KY 225

42001 McCracken, KY 210

42025 Marshall, KY 112

42066 Graves, KY 95

62960 Massac 91Metropolis



42445 Caldwell, KY 44

42071 Calloway, KY 41


42064 Crittendon, KY 29

42058 Livingston, KY 24

62910 Massac 24Brookport


42038 Lyon, KY 23

42023 Carlisle, KY 20

42027 Graves, KY 16

42051 Graves, KY 16


42087 Ballard, KY 15

42056 Ballard, KY 15

42055 Lyon, KY 14

62938 Pope 14Golconda




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Pain Care Surgery MarionAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 563

028458310344

1,014

040791918170

1,577




TOTAL 563

403434

0172

50

1,014

584676

14293

100

1,577




288,98579,870 4,471 68,837 32,615 474,778

60.9%16.8% 0.9% 14.5% 6.9%


0

Charity Care

Expense

0%



Reference Numbers

005

7002900

199

Pain Care Surgery

108 Airway Drive

Marion, IL 62959

Administrator

Laxmaiah Manchikanti MD


Registered Agent


Property Owner

N./A

Legal Owner(s)

Facility Id



Patricia Burks 270-554-8373




Exam Rooms 3

Procedure Rooms 1



TOTAL 10.00

STAFFING PATTERNS



Type of Ownership




Heartland Regional Hospital 0




Exam Rooms 3

Procedure Rooms 1

Kavita Manchikanti MD


Yogesh Malla MD

of 292 2/7/2020


Pain Care Surgery MarionAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00


62948 Williamson 124Herrin

62946 Saline 105Harrisburg



62918 Williamson 56Carterville

62930 Saline 42Eldorado

62951 Williamson 38Johnston City

62922 Williamson 35Creal Springs

62821 White 34Carmi

62901 Jackson 28Carbondale


62964 Pulaski 27Mounds

62939 Johnson 27Goreville

62995 Johnson 25Vienna

62966 Jackson 22Murphysboro

62865 Franklin 21Mulkeytown

62906 Union 20Anna

62938 Pope 20Golconda


62859 Hamilton 18Mc Leansboro

62960 Massac 17Metropolis

62933 Williamson 16Energy




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000

Pain Management 1577 160 210 0.233701

of 292 2/7/2020


Phjysicians' Surgery Centr, LLC CarbondaleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,410

15464673379276

1,807

42756

1,153745521

3,217




TOTAL 1,410

34864426

7671210

1,807

5691,181

971,326

2717

3,217




388,8071,275,114 106,251 2,359,789 8,193 4,138,154

9.4%30.8% 2.6% 57.0% 0.2%


2,356

Charity Care

Expense

0%



Reference Numbers

005

7003128

077

Phjysicians' Surgery Centr, LLC

2601 West Main Street

Carbondale, IL 62901

Administrator

Stephen Renfro


Registered Agent

William Sherwood

Property Owner

Southern IL Healthcare

Legal Owner(s)

Facility Id



Stephen Renfro 618-351-7300




Exam Rooms 0

Procedure Rooms 1



TOTAL 24.00

STAFFING PATTERNS



Type of Ownership




Memorial Hospital of Carbondale 4




Exam Rooms 0

Procedure Rooms 1

Adrian Martin, MD

Don Arnold II, MD

Douglas Gates, MD

Gardner Kenny, MD

Sam Stokes III, MD

Southern Illinois Healthcar

Sylvia Garwin, MD

of 292 2/7/2020


Phjysicians' Surgery Centr, LLC CarbondaleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,260.00 700.00TOTAL 2822 1960.00 0.69

62901 278Carbondale

62959 223Marion

62966 214Murphysboro

62918 146Carterville

62948 126Herrin

62896 98West Frankfort

62832 97DuQuoin

62906 81Anna

62902 80Carbondale

62812 64Benton

62951 56Johnston City

62946 53Harrisburg

62974 51Pittsburg

62958 48Makanda

62924 47De Soto

62939 41Goreville

62920 36Cobden

62903 33Carbondale

62995 33Vienna

62952 32Jonesboro

62930 26Eldorado

62822 25Christopher

62907 25Ava

62932 25Elkville



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Physicians Surgery Center at Good Samaritan, LL Mt. VernonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,349

56328491329226

1,430

125545967692450

2,779




TOTAL 1,349

250584

4587

50

1,430

3681,188

101,201

120

2,779




165,9681,480,389 11,171 5,181,762 20,160 6,859,450

2.4%21.6% 0.2% 75.5% 0.3%


2,125

Charity Care

Expense

0%



Reference Numbers

005

7003172

081

Physicians Surgery Center at Good Samaritan, LLC

2 Good Samaritan Way, Suite 200

Mt. Vernon, IL 62864

Administrator

Melinda Cain


Registered Agent

CT Corporation

Property Owner

Frauenshuh Hospitality

Legal Owner(s)

Facility Id



Melinda Cain 618-899-5703




Exam Rooms 0

Procedure Rooms 1



TOTAL 26.00

STAFFING PATTERNS



Type of Ownership




SSM Regional Health Center Hospital, Mt. Vernon 5




Exam Rooms 0

Procedure Rooms 1

A. Scott Harad, MD

Angela Freehill-Brown, MD

Don Kovalsky, MD

FPP, Inc

Jean-Benoit Houle, MD

Jeffrey Maher, MD

Joon Ahn, MD

Kevin Claffey, MD

Prateek Srinet, MD

SDP LLC

USP Mt. Vernon, Inc

of 292 2/7/2020


Physicians Surgery Center at Good Samaritan, LL Mt. VernonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,662.00 472.50TOTAL 2152 2134.50 0.99




62859 Hamilton 136Mc Leansboro

62881 Marion 110Salem

62837 Wayne 74Fairfield

62884 Franklin 70Sesser

62895 Wayne 69Wayne City

62816 Jefferson 53Bonnie

62263 Washington 52Nashville

62898 Jefferson 52Woodlawn


62814 Jefferson 47Bluford

62830 Jefferson 45Dix

62810 Jefferson 43Belle Rive

62828 Hamilton 41Dahlgren

62808 Washington 36Ashley

62872 Jefferson 32Opdyke

62849 Marion 31Iuka

62839 Clay 28Flora

62894 Jefferson 27Waltonville



62854 Marion 21Kinmundy



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Southern Illinois Orthopedic Center, LLC HerrinAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,300

32279597259141

1,308

81718

1,141451217

2,608




TOTAL 1,300

8735813

84280

1,308

172589

401,784

230

2,608




193,452672,323 75,769 7,644,867 63,327 8,649,738

2.2%7.8% 0.9% 88.4% 0.7%


960

Charity Care

Expense

0%



Reference Numbers

005

7002421

199

Southern Illinois Orthopedic Center, LLC

510 Lincoln Dr

Herrin, IL 62948-3738

Administrator

Greg Thompson


Registered Agent

Richard Morgan, MD

Property Owner

Legal Owner(s)

Facility Id



Greg Thompson 618-997-4310




Exam Rooms 1

Procedure Rooms 0



TOTAL 40.00

STAFFING PATTERNS



Type of Ownership




Herrin Hospital Herrin IL 5




Exam Rooms 1

Procedure Rooms 0

Southern IL Healthcare Ser

Southern Orthopedic Asso

of 292 2/7/2020


Southern Illinois Orthopedic Center, LLC HerrinAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,910.27 1,467.54TOTAL 2608 4377.81 1.68

62959 WILLIAMSON 337Marion

62966 JACKSON 166Murphysboro

62901 JACKSON 143Carbondale

62948 WILLIAMSON 143Herrin

62918 WILLIAMSON 126Carterville

62896 FRANKLIN 123West Frankfort

62832 PERRY 91DuQuoin

62812 FRANKLIN 89Benton

62951 WILLIAMSON 76Johnston City

62902 JACKSON 69Carbondale

62946 SALINE 67Harrisburg

62906 UNION 60Anna

62274 PERRY 47Pinckneyville

62939 JOHNSON 41Goreville

62920 UNION 38Cobden

62922 WILLIAMSON 34Creal Springs

62930 SALINE 34Eldorado

62995 JOHNSON 32Vienna

62924 JACKSON 32De Soto

62822 FRANKLIN 32Christopher

62890 FRANKLIN 27Thompsonville

62907 JACKSON 27Ava

62974 WILLIAMSON 26Pittsburg

62958 JACKSON 25Makanda



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Surgery Center of Centralis CentraliaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 756

0163298249206

916

1252529476414

1,672




TOTAL 756

168488

6249

50

916

239917

23481

120

1,672




109,034689,687 11,222 832,723 25,414 1,668,079

6.5%41.3% 0.7% 49.9% 1.5%


0

Charity Care

Expense

0%



Reference Numbers

005

7002298

121

Surgery Center of Centralis

1045 ML King Drive

Centralia, IL 62801

Administrator

Jason Fischer


Registered Agent

National Registered Agents, In

Property Owner

Legal Owner(s)

Facility Id



Jason Fischer 618-532-3110




Exam Rooms 0

Procedure Rooms 1



TOTAL 10.00

STAFFING PATTERNS



Type of Ownership




St Mary's Hospital, Centralia 2Salem Township Hospital 0Crossroads Community Hospital 0




Exam Rooms 0

Procedure Rooms 1

Brenda & Mark Murfi

Community Care, Inc

Jeffrey Maher

M.A. Junidi

SDPOBGYN, LLC

of 292 2/7/2020


Surgery Center of Centralis CentraliaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


547.00 510.00TOTAL 1197 1057.00 0.88

62801 MARION 679Centralia

62881 MARION 173Salem

62864 JEFFERSON 120Mount Vernon

62882 MARION 73Sandoval

62870 MARION 62Odin

62231 CLINTON 41Carlyle

62893 MARION 39Walnut Hill

62875 MARION 29Patoka

62263 WASHINGTON 28Nashville

62853 MARION 21Kell

62807 MARION 21Alma

62854 MARION 20Kinmundy

62812 BOND 20Benton

62808 WASHINGTON 16Ashley

62803 WASHINGTON 15Hoyleton

62877 WASHINGTON 14Richview

62830 JEFFERSON 12Dix

62839 CLAY 12Flora

62250 CLINTON 12Hoffman

62837 WAYNE 10Fairfield

62471 FAYETTE 10Vandalia

62848 WASHINGTON 10Irvington

62846 JEFFERSON 9Ina

62859 HAMILTON 9Mc Leansboro



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE


Gastroenterology 380 284.5 142 1.12426.5


Laser Eye 95 11.5 18 0.3129.5

of 292 2/7/2020


25 East Same Day Surgery, LLC ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 893

3267406331182

1,189

4504730511333

2,082




TOTAL 893

2439

0672760

1,189

4715

11,263

990

2,082




-18,915833,278 746 4,018,931 166,047 5,000,087

-0.4%16.7% 0.0% 80.4% 3.3%


0

Charity Care

Expense

0%



Reference Numbers

006

7001969

030

25 East Same Day Surgery, LLC

25 East Washington Street, Ste 300

Chicago, IL 60602

Administrator

Catherine Weaver


Registered Agent


Property Owner

Aspire Properties

Legal Owner(s)

Facility Id



Brenna Fazio 630-325-5035




Exam Rooms 0

Procedure Rooms 0



TOTAL 24.00

STAFFING PATTERNS



Type of Ownership




Northshore Hospital 3




Exam Rooms 0

Procedure Rooms 0

Ari Jacob Kaz, MD

Colman Kraff, MD

George Bucciero, DPM

Jingtao Guo, MD

Kevin Wei-Ta Chen

Levi Gabriel, MD

Mary Szatkowski, MD

Northshore/USP Surgery P

Pamela Eernisse, DPM

Sajjad Murtaza, MD

Sanjay Rao, MD

Scott Rubinstein, MD

of 292 2/7/2020


25 East Same Day Surgery, LLC ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.000 0.00 0.00General 0.00 0.000 0.00 0.00Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 24.37 91.8265 116.19 1.79Ophthalmology 325.05 1,687.02954 2012.07 2.11Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 474.37 1,139.80513 1614.17 3.15Otolaryngology 0.00 0.000 0.00 0.00Pain Management 84.38 419.78301 504.16 1.67Plastic Surgery 131.43 239.1772 370.60 5.15Podiatry 143.68 332.65173 476.33 2.75Thoracic 0.00 0.000 0.00 0.00Urology 1.60 3.514 5.11 1.28

1,184.88 3,913.75TOTAL 2082 5098.63 2.45

60616 cook 107Chicago























60035 lake 17Highland Park



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Advanced Ambulatiry Surgical Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 548

084

231188176

679

0173443303308

1,227




TOTAL 548

0384

0254374

679

0625

0487107

8

1,227




0753,508 0 950,721 206,046 1,910,275

0.0%39.4% 0.0% 49.8% 10.8%


13,750

Charity Care

Expense

1%



Reference Numbers

006

7002256

030

Advanced Ambulatiry Surgical Center

233 N. Harlem Ave

Chicago, IL 60707

Administrator

Dr. Severko Hrywnak


Registered Agent

Robert Polovin

Property Owner

2333 N.HARLEM LIMIT

Legal Owner(s)

Facility Id



Joanna Brzostowska 773-637-1700




Exam Rooms

Procedure Rooms



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership

Sole Proprietorship



01




Exam Rooms

Procedure Rooms

Severko Hrywnak

of 292 2/7/2020


Advanced Ambulatiry Surgical Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


923.90 409.00TOTAL 1227 1332.90 1.09

60707 COOK 135Elmwood Park

60634 COOK 126Norridge

60706 COOK 53Harwood Heights


60641 COOK 42Chicago


60131 COOK 39Franklin Park



60164 COOK 32Melrose Park


60176 COOK 25Schiller Park


60104 COOK 22Bellwood

60171 COOK 22River Grove

60016 COOK 21Des Plaines

60516 DUPAGE 18Downers Grove

60068 COOK 16Park Ridge


60056 COOK 15Mount Prospect

60126 DUPAGE 14Elmhurst

60153 COOK 14Maywood





PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Bemont/Harlam Surgery Center, LLC ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,253

2112506531528

1,679

3257910910852

2,932




TOTAL 1,253

2718

0948110

1,679

31,171

01,731

270

2,932




17,8681,422,467 0 3,248,864 39,884 4,729,082

0.4%30.1% 0.0% 68.7% 0.8%


3,763

Charity Care

Expense

0%



Reference Numbers

006

7003131

030

Bemont/Harlam Surgery Center, LLC

3101 N. Harlem Ave.

Chicago, IL 60634

Administrator

Faith McHale


Registered Agent

Faith McHale

Property Owner

Presence Health

Legal Owner(s)

Facility Id



Faith McHale 773-889-2000




Exam Rooms

Procedure Rooms



TOTAL 15.11

STAFFING PATTERNS



Type of Ownership




Presence Health 3




Exam Rooms

Procedure Rooms

Alan Sadah

Anthony Grande

Brian Mccall

Christopher Mahr

Gregory Fahrenbac

Hong Vo

Jasmeet Dhaliwal

Kevin Sullivan

Manus Kraff

Marian Skolarz

Michelle Lipman

Natik Patel

Presence Health

Richard Hayek

Todd Rimington

Tomasz Szmyd

of 292 2/7/2020


Bemont/Harlam Surgery Center, LLC ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,184.25 967.50TOTAL 2932 2151.75 0.73







60068 COOK 133Park Ridge





60714 COOK 56Niles






60176 COOK 26Schiller Park

60171 COOK 21River Grove

60642 Cook 19Evergreen Park


60070 COOK 16Prospect Heights

60074 COOK 13Palatine




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Chicago Endoscopy Center, ASTC Chicago AMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 352

01001355929

323

021829511052

675




TOTAL 356

010018

169311

319

0167

36370

993

675




11,605532,811 207,474 1,251,728 207,474 2,211,092

0.5%24.1% 9.4% 56.6% 9.4%


3,475

Charity Care

Expense

0%



Reference Numbers

006

7003126

030

Chicago Endoscopy Center, ASTC

3536 w, Fullerton Avenue

Chicago , IL 60647

Administrator

Ramon A. Garcia, MD


Registered Agent

Kara Friedman

Property Owner

Garcia Properties

Legal Owner(s)

Facility Id



Karen Zimmerman 773-772-1212




Exam Rooms

Procedure Rooms 1


Director of NursesRegistered Nurses 1.00Certified Aides 3.00Other Health Profs.Other Non-Health Profs

TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Naorwegian American Hospital 0




Exam Rooms

Procedure Rooms 1

Ramon A. Garcia, MD

of 292 2/7/2020


Chicago Endoscopy Center, ASTC Chicago AMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

60639 Cook 90Chicago




60634 Cook 25Norridge

60804 Cook 21Cicero

60707 Cook 19Elmwood Park










60623 Cook 9Chicago

60402 Cook 9Berwyn

60614 Cook 8Chicago

60632 Cook 8Chicago

60645 Cook 6Chicago

60505 Kane 6Aurora

60016 Cook 5Des Plaines




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000

ObGyne 1 0.33 0.5 0.830.83

of 292 2/7/2020


Fullerton Kimball Medical & Surgical Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 420

048

1668358

355

212038717492

775




TOTAL 420

0254

09461

355

0521

0239

141

775




213284,051 0 507,843 171,971 964,078

0.0%29.5% 0.0% 52.7% 17.8%


27,000

Charity Care

Expense

3%



Reference Numbers

006

7003181

030

Fullerton Kimball Medical & Surgical Center

3412 W Fullerton Ave

Chicago, IL 60647-2416

Administrator

Julie Swanson


Registered Agent

John Boland - Daluga Boland &

Property Owner

Legal Owner(s)

Facility Id



Julie Swanson 773-235-8000




Exam Rooms 2

Procedure Rooms 0



TOTAL 12.00

STAFFING PATTERNS



Type of Ownership




Norwegian American Hospital, Chicago 0




Exam Rooms 2

Procedure Rooms 0

Renlin Xia

of 292 2/7/2020


Fullerton Kimball Medical & Surgical Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


518.75 572.75TOTAL 775 1091.50 1.41





60406 COOK 21Blue Island










60827 COOK 12Riverdale

60440 WILL 12Bolingbrook




60120 COOK 11Elgin

60803 COOK 10Alsip


47909 TIPPECANOE 10




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Fullerton Surgery Center, Ltd ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 452

054

34411015

523

012962119629

975




TOTAL 452

6430

46734

523

8770

872126

975




9,01453,165 0 2,357,198 68,522 2,487,899

0.4%2.1% 0.0% 94.7% 2.8%


23,000

Charity Care

Expense

1%



Reference Numbers

006

7002827

030

Fullerton Surgery Center, Ltd

4849 W Fullerton Ave

Chicago, IL 60639

Administrator

Abdelsalam Okasha


Registered Agent

Norman Jeddloh

Property Owner

Naser Rustom, MD

Legal Owner(s)

Facility Id



Amela Mehmedinovic 773-237-2900




Exam Rooms 1

Procedure Rooms 0



TOTAL 10.00

STAFFING PATTERNS



Type of Ownership

Sole Proprietorship



St. Mary of Nazareth Hospital, Chicago 0




Exam Rooms 1

Procedure Rooms 0

Naser Rustom, MD

of 292 2/7/2020


Fullerton Surgery Center, Ltd ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


525.00 528.50TOTAL 975 1053.50 1.08







60409 COOK 21Calumet City

60642 COOK 20Evergreen Park


60904 COOK 18

60452 COOK 17Oak Forest

60804 COOK 16Cicero


60402 COOK 15Berwyn

60827 COOK 15Riverdale



60202 COOK 15Evanston

60712 COOK 13Lincolnwood

60457 COOK 13Hickory Hills

60453 COOK 13Oak Lawn



60302 COOK 12Oak Park



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Gold Coast Surgicenter, LLC ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,661

27396119025

1,467

61,6731,238

17536

3,128




TOTAL 1,661

0660

1,182219

0

1,467

0120

02,743

2650

3,128




0266,686 0 16,589,453 0 16,856,139

0.0%1.6% 0.0% 98.4% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

006

7003150

030

Gold Coast Surgicenter, LLC

845 N. Michigan Ave, Suite 985w

Chicago, IL 60611

Administrator

Craig Filippi


Registered Agent


Property Owner

Watertower, LLC

Legal Owner(s)

Facility Id



Tina Santiago 312-521-5500




Exam Rooms

Procedure Rooms



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Northwestern Memorial Hospital 4Rush University Medical Center 1




Exam Rooms

Procedure Rooms

Adam Yanke, MD

Anil Shah, MD

Anthony Romeo, MD

Brian Cole, MD

Brian Forsythe, MD

Ed Goldberg, MD

Frank Phillips, MD

Greg Nicholson, MD

John Fernandez, MD

Kern Singh, MD

Mark Cohen, MD

Nikhil Verma, MD

Nuehealth Management

Robert Wysocki, MD

Roberto Diaz, MD

Shane Nho, MD

Tad Gerlinger, MD

of 292 2/7/2020


Gold Coast Surgicenter, LLC ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


3,145.00 1,195.35TOTAL 3128 4340.35 1.39



















46307 LAKE 27



60304 COOK 23Oak Park





PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Grand Avenue Surgical Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 194

099

12391

232

118821519

3

426




TOTAL 194

000

113115

4

232

000

206214

6

426




00 0 748,349 773,538 1,521,887

0.0%0.0% 0.0% 49.2% 50.8%


14,135

Charity Care

Expense

1%



Reference Numbers

006

7003133

030

Grand Avenue Surgical Center

17 W Grand Ave

Chicago, IL 60654

Administrator

Joe Jafari


Registered Agent

Sarah Jafari

Property Owner

Parliament Enterprises

Legal Owner(s)

Facility Id



Joe Jafari 312-222-5610




Exam Rooms 1

Procedure Rooms



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Norwegian American Hospital, Chicago IL 0




Exam Rooms 1

Procedure Rooms

Javad Jafari

Sarah Jafari

of 292 2/7/2020


Grand Avenue Surgical Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


344.00 241.50TOTAL 426 585.50 1.37









60804 COOK 10Cicero

60647 COOK 9Chicago

60505 DUPAGE 9Aurora


60617 COOK 8Chicago

60651 COOK 8Chicago

60630 COOK 6Chicago

60644 COOK 6Chicago

60527 DUPAGE 6Willowbrook

60652 COOK 6Chicago


60613 COOK 6Chicago

60090 COOK 5Wheeling

60608 COOK 5Chicago

60542 KANE 5North Aurora

60429 COOK 5Hazel Crest



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Hyde Park Surgical Center, LLC ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 705

02393019936

675

052064714766

1,380




TOTAL 705

0115

064

4960

675

0178

0120

1,0793

1,380




01,056,123 0 2,857,362 6,079,453 9,992,938

0.0%10.6% 0.0% 28.6% 60.8%


44,700

Charity Care

Expense

0%



Reference Numbers

006

7003196

030

Hyde Park Surgical Center, LLC

1644 E 53rd St

Chicago, IL 60615

Administrator

Melissa Rice


Registered Agent

Stuart Gimbel

Property Owner

Legal Owner(s)

Facility Id



Melissa Rice 773-752-6340




Exam Rooms 0

Procedure Rooms 0



TOTAL 6.00

STAFFING PATTERNS



Type of Ownership




Mercy Hospital, Chicago 1




Exam Rooms 0

Procedure Rooms 0

Darrel Saldanha

David Saldanha

of 292 2/7/2020


Hyde Park Surgical Center, LLC ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


866.00 786.00TOTAL 1380 1652.00 1.20






60804 Cook 29Cicero


60411 Cook 24Chicago Heights









60409 Cook 17Calumet City

60827 Cook 16Riverdale


60402 Cook 14Berwyn


60106 DuPage 13Bensenville


60419 Cook 13Dolton



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Lakeshore Surgery Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 316

0101107

80

216

024726519

1

532




TOTAL 316

000

21420

216

002

510200

532




00 0 3,735,455 75,900 3,811,355

0.0%0.0% 0.0% 98.0% 2.0%


0

Charity Care

Expense

0%



Reference Numbers

006

7002975

030

Lakeshore Surgery Center

7200 N Western Ave

Chicago, IL 60645

Administrator

Philippe Espinosa


Registered Agent

Jayme R Matchinski

Property Owner

Legal Owner(s)

Facility Id



Mira Pekic 773-761-6900




Exam Rooms 1

Procedure Rooms 0



TOTAL 11.00

STAFFING PATTERNS



Type of Ownership




St. Francis Hospital, Evanston 1Methodist Hospital, Chicago 0




Exam Rooms 1

Procedure Rooms 0

Raghuveer Nayak

of 292 2/7/2020


Lakeshore Surgery Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,017.00 412.00TOTAL 1175 1429.00 1.22


60804 COOK 15Cicero



60505 KANE 12Aurora







60085 LAKE 9Waukegan

60618 COOK 8Chicago

60657 COOK 8Chicago

60608 COOK 8Chicago

60641 COOK 8Chicago

60625 COOK 7Chicago

60653 COOK 7Chicago

60506 KANE 7Aurora

60644 COOK 7Chicago

60626 COOK 7Chicago


60101 DU PAGE 7Addison

60617 COOK 6Chicago



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


NovaMed Surgery Center of Chicago Northshore, ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,255

016

292602633

1,543

030

5871,0651,116

2,798




TOTAL 1,255

1831,102

0221325

1,543

3121,917

1495

676

2,798




234,1392,357,303 0 970,959 393,550 3,955,951

5.9%59.6% 0.0% 24.5% 9.9%


1,165

Charity Care

Expense

0%



Reference Numbers

006

7002678

030

NovaMed Surgery Center of Chicago Northshore, LLC

3034 W. Peterson Aveue

Chicago, IL 60659

Administrator

Kim Nordby


Registered Agent


Property Owner

JCB Building, LLC

Legal Owner(s)

Facility Id



Kim Nordby 773-973-7432




Exam Rooms 0

Procedure Rooms 1



TOTAL 15.00

STAFFING PATTERNS



Type of Ownership




Swedish Covenant Hospital, Chicago 1




Exam Rooms 0

Procedure Rooms 1

David Greenberg, MD

Dimitri Perros, MD

GersteinASC Interests,LLC

Grace Bai, MD

Kathleen Scarpulla, MD

Lawrence Wolin, MD

of 292 2/7/2020


NovaMed Surgery Center of Chicago Northshore, ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


656.00 349.87TOTAL 2624 1005.87 0.38




60076 Cook 99Skokie


60077 Cook 93Skokie




60004 Cook 78Arlington Heights



60056 Cook 70Mount Prospect



60067 Cook 64Palatine

60712 Cook 60Lincolnwood



60714 Cook 50Niles

60193 Cook 45Roselle

60089 Lake 40Buffalo Grove

60090 Cook 39Wheeling




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 174 5 6 0.06111


of 292 2/7/2020


Peterson Medical Surgi-Center, SC ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 55

0181800

36

05041

00

91




TOTAL 55

000

3420

36

000

8650

91




00 0 626,774 19,200 645,974

0.0%0.0% 0.0% 97.0% 3.0%


0

Charity Care

Expense

0%



Reference Numbers

006

7002918

030

Peterson Medical Surgi-Center, SC

2300 W. Peterson Avenue

Chicago, IL 60659

Administrator

Aref Senno, MD


Registered Agent

Aref Senno, MD

Property Owner

Legal Owner(s)

Facility Id



Patty Horne 773-508-9800




Exam Rooms 0

Procedure Rooms 0



TOTAL 3.00

STAFFING PATTERNS



Type of Ownership




Swedish Covenant Hospital 0




Exam Rooms 0

Procedure Rooms 0

Aref Senno, MD

of 292 2/7/2020


Peterson Medical Surgi-Center, SC ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


42.25 50.75TOTAL 91 93.00 1.02

60505 Kane 7Aurora

60651 Cook 5Chicago

60629 Cook 4Chicago

60623 Cook 4Chicago

60402 Cook 4Berwyn

60619 Cook 3Chicago

60608 Cook 3Chicago

60628 Cook 3Chicago

60656 Cook 2Harwood Heights

60621 Cook 2Chicago

60626 Cook 2Chicago

60624 Cook 2Chicago

60804 Cook 2Cicero

60647 Cook 2Chicago

60659 Cook 2Chicago

60610 Cook 2Chicago

60419 Cook 2Dolton

60649 Cook 2Chicago

60625 Cook 2Chicago

60026 Cook 2Glenview

60609 Cook 2Chicago

60504 Kane 2Aurora


60406 Cook 1Blue Island



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


River North Sameday Surgery ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 976

644039412930

999

990274824967

1,975




TOTAL 969

0129

3674200

0

1,006

1247

41,486

2370

1,975




32311,896 6,189 4,975,936 472,579 5,766,632

0.0%5.4% 0.1% 86.3% 8.2%


0

Charity Care

Expense

0%



Reference Numbers

006

7002090

030

River North Sameday Surgery

1 East Erie, Suite 300

Administrator

Meaghan Reshoft


Registered Agent

CT Corp System

Property Owner

G&I VII MJW One E E

Legal Owner(s)

Facility Id



Meaghan Reshoft 312-649-3939




Exam Rooms 1

Procedure Rooms 0



TOTAL 16.20

STAFFING PATTERNS



Type of Ownership




No Direct Hospital Transfers 0




Exam Rooms 1

Procedure Rooms 0

Charles Carroll

Chirag Shah

Gordon Siegel

John Hefferon

John Stogin

Jordan Pritikin

Mark Bowen

Michael Byun

Patrick Birmingham

Steven levin

Thomas Wiedrich

of 292 2/7/2020


River North Sameday Surgery ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,588.02 778.05TOTAL 1975 3366.07 1.70











60093 Cook 34Winnetka



60068 Cook 27Park Ridge

60062 Cook 26Northbrook


60201 Cook 26Evanston





60202 Cook 22Evanston

60091 Cook 21Wilmette

60642 CCOK 20Evergreen Park



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Rogers Park One Day Surgery Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 0

00000

0

00000

0




TOTAL 181

0503

2240

232

0508

4000

413




00 0 0 0 0

#Num!#Num! #Num! #Num! #Num!


0

Charity Care

Expense

0%


Total Net Revenue#Type!

Reference Numbers

006

7003218

030

Rogers Park One Day Surgery Center

7616 N Paulina St

Chicago, IL 60626

Administrator

Luis Lozada


Registered Agent

Property Owner

Mohamed Siraj

Legal Owner(s)

Facility Id



Nadia Ghazali 773-760-0500




Exam Rooms 2

Procedure Rooms 1


Director of Nurses 0.00Registered Nurses 1.00Certified Aides 0.00Other Health Profs.Other Non-Health Profs 5.00

TOTAL

STAFFING PATTERNS



Type of Ownership

Sole Proprietorship






Exam Rooms 2

Procedure Rooms 1

Mohamed Siraj

of 292 2/7/2020


Rogers Park One Day Surgery Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 360 0.00 0.00








60631 Cook 9Chicago

60609 Cook 8Chicago

60613 Cook 7Chicago

60610 Cook 6Chicago

60659 Cook 6Chicago

60651 Cook 6Chicago

60622 Cook 6Chicago

60804 Cook 5Cicero


60620 Cook 5Chicago

60638 Cook 5Chicago

60623 Cook 5Chicago

60516 Du Page 5Downers Grove

60644 Cook 5Chicago

60632 Cook 4Chicago

60608 Cook 4Chicago




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Rush SurgiCenter-Professional Building ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,366

16943

1,439656433

3,487

291,7952,3951,022

612

5,853




TOTAL 2,366

01,252

392,128

680

3,487

01,787

573,886

1221

5,853




04,241,534 177,354 19,984,283 223,896 24,627,068

0.0%17.2% 0.7% 81.1% 0.9%


0

Charity Care

Expense

0%



Reference Numbers

006

7001753

030

Rush SurgiCenter-Professional Building

1725 W Harrison St

Chicago, IL 60612

Administrator

Katherine Carlson


Registered Agent

Carl Bergetz

Property Owner

Rush University Medical

Legal Owner(s)

Facility Id



Katherine Carlson 312-563-2883




Exam Rooms 0

Procedure Rooms 0



TOTAL 49.00

STAFFING PATTERNS



Type of Ownership




Rush University Medical Center, Chicago 14




Exam Rooms 0

Procedure Rooms 0

Midwest Orthopedic Rush

Rush University Medical

University Pain

of 292 2/7/2020


Rush SurgiCenter-Professional Building ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.000 0.00 0.00General 22.75 69.0018 91.75 5.10Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 55.00 23.0069 78.00 1.13Ophthalmology 201.00 232.00424 433.00 1.02Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 3,049.00 2,497.002283 5546.00 2.43Otolaryngology 72.00 12.0029 84.00 2.90Pain Management 1,346.00 1,088.002873 2434.00 0.85Plastic Surgery 108.75 75.0064 183.75 2.87Podiatry 17.00 7.0013 24.00 1.85Thoracic 0.00 0.000 0.00 0.00Urology 90.00 65.0080 155.00 1.94

4,961.50 4,068.00TOTAL 5853 9029.50 1.54













60126 DuPage 60Elmhurst







60402 Cook 52Berwyn

60148 DuPage 48Lombard



60302 Cook 46Oak Park



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Six Corners Sameday Surgery LLC ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 4

01600

7

02900

11




TOTAL 4

000610

7

000

1010

11




00 0 0 0 0



0

Charity Care

Expense

0%



Reference Numbers

006

7002645

030

Six Corners Sameday Surgery LLC

4211 N Cicero Ave Ste 400

Chicago, IL 60641

Administrator

Sarmed G. Elias MD


Registered Agent

Sarmed G. Elias MD

Property Owner

Cicero Investment Assoc

Legal Owner(s)

Facility Id



Ken Riesterer 773-545-6900




Exam Rooms 3

Procedure Rooms 1



TOTAL 13.00

STAFFING PATTERNS



Type of Ownership




Swedish Covenant Hospital 0First Community Hospital 0




Exam Rooms 3

Procedure Rooms 1

Sarmed G. Elias MD

of 292 2/7/2020


Six Corners Sameday Surgery LLC ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


11.74 7.67TOTAL 11 19.41 1.76


60076 COOK 2Skokie

60402 COOK 1Berwyn

60156 MCHENRY 1Lake in the Hills

22642 LINDEN 1

60639 COOK 1Chicago

60620 COOK 1Chicago

60638 COOK 1Chicago



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


South Loop Endoscopy And Wellness Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,422

045485919550

1,558

1886

1,57042598

2,980




TOTAL 1,422

2172

01,342

420

1,558

6315

02,553

1060

2,980




7,471149,615 0 2,561,290 85,719 2,804,095

0.3%5.3% 0.0% 91.3% 3.1%


0

Charity Care

Expense

0%



Reference Numbers

006

7003171

030

South Loop Endoscopy And Wellness Center

2340 S Wabash Ave.

Chicago, IL 60616

Administrator

Jiaxi Gao


Registered Agent

Business Filings, Inc.

Property Owner

Sunrise Real Estate LLC

Legal Owner(s)

Facility Id



Jiaxi Gao 312-808-0468




Exam Rooms

Procedure Rooms 2


Director of Nurses 1.00Registered Nurses 2.00Certified Aides 1.00Other Health Profs. 4.00Other Non-Health Profs

TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership







Exam Rooms

Procedure Rooms 2

David Chua

of 292 2/7/2020


South Loop Endoscopy And Wellness Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

60639 247Chicago

60647 183Chicago

60641 142Chicago

60632 141Chicago

60616 138Chicago

60651 118Chicago

60634 114Norridge

60608 105Chicago

60618 89Chicago

60622 89Chicago

60609 64Chicago

60629 64Chicago

60625 45Chicago

60804 44Cicero

60707 41Elmwood Park

60623 41Chicago

60657 41Chicago

60638 39Chicago

60402 36Berwyn

60613 33Chicago

60459 32Burbank

60630 31Chicago

60614 31Chicago

60642 28Evergreen Park



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Surgicore ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 35

120423010

103

334573212

138




TOTAL 35

0341

6800

103

0394

9500

138




078,836 447,703 0 0 526,539

0.0%15.0% 85.0% 0.0% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

006

7003072

030

Surgicore

10547 S. Ewing Ave.

Chicago, IL 60617

Administrator

Dr. Michael A. Wood, D.P.M.


Registered Agent

John Roberts

Property Owner

Michael A. Wood

Legal Owner(s)

Facility Id



Victoria Gambino, R.N. 773-221-1690




Exam Rooms

Procedure Rooms


Director of Nurses 1.00Registered NursesCertified AidesOther Health Profs. 1.00Other Non-Health Profs

TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Franciscan Alliance, Hammond, IN 0Bud's Ambulance 0




Exam Rooms

Procedure Rooms

Michael A. Wood

of 292 2/7/2020


Surgicore ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


144.50 25.50TOTAL 138 170.00 1.23


60438 COOK 30Lansing

60409 COOK 9Calumet City

60419 COOK 5Dolton

46324 LAKE 4

46320 LAKE 3

46307 LAKE 2

47951 NEWTON 2

46323 LAKE 2

46322 LAKE 2

46345 LAPORTE 2

60417 WILL 2Crete

60411 COOK 2Chicago Heights

60431 WILL 2Joliet

60620 COOK 2Chicago

60605 COOK 2Chicago

60461 COOK 2Olympia Fields

46321 LAKE 2

60484 WILL 1University Park

60475 COOK 1Steger

60401 WILL 1Beecher

60628 COOK 1Chicago

46327 LAKE 1

46368 PORTER 1



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


The Surgery Center at 900 North Michigan Surgica ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 772

52,393

97624495

3,713

62,7101,278

347144

4,485




TOTAL 772

1200

21,5092,001

0

3,713

1307

81,9312,238

0

4,485




150300,188 0 6,701,985 4,314,715 11,317,038

0.0%2.7% 0.0% 59.2% 38.1%


0

Charity Care

Expense

0%



Reference Numbers

006

7002272

030

The Surgery Center at 900 North Michigan Surgical

60 E Delaware Place, 15th Floor

Chicago, IL 60611

Administrator

Guita Griffiths


Registered Agent

Kenneth A Goldstein; Horwood,

Property Owner

JMB

Legal Owner(s)

Facility Id



Patty Wamsley, CASC 312-944-5727




Exam Rooms

Procedure Rooms 2



TOTAL 35.00

STAFFING PATTERNS



Type of Ownership




Northwestern Memorial Hospital 4




Exam Rooms

Procedure Rooms 2

900 North Equity Holdings

Ilan Tur-Kuspa, MD

John McMahan, MD

Neeraj Jain, MD

Peter Geldner, MD

Steven Stryker, MD

Thomas Mustoe, MD

of 292 2/7/2020


The Surgery Center at 900 North Michigan Surgica ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.000 0.00 0.00General 39.75 55.75101 95.50 0.95Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 92.50 89.00162 181.50 1.12OB/Gynecology 446.50 271.75494 718.25 1.45Ophthalmology 278.50 133.75287 412.25 1.44Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 0.00 0.000 0.00 0.00Otolaryngology 816.00 99.00180 915.00 5.08Pain Management 5.75 11.5034 17.25 0.51Plastic Surgery 4,711.50 1,042.751896 5754.25 3.03Podiatry 5.25 2.505 7.75 1.55Thoracic 0.00 0.000 0.00 0.00Urology 100.75 33.0060 133.75 2.23

6,496.50 1,739.00TOTAL 3219 8235.50 2.56

60611 197Chicago

60614 163Chicago

60657 136Chicago

60610 123Chicago

60618 88Chicago

60622 88Chicago

60654 88Chicago

60613 85Chicago

60647 81Chicago

60640 68Chicago

60605 63Chicago

60616 60Chicago

60601 49Chicago

60645 48Chicago

60625 48Chicago

60607 46Chicago

60641 44Chicago

60660 44Chicago

60634 40Norridge

60615 39Chicago

60661 37Chicago

60608 36Chicago

60626 35Chicago

60638 35Chicago



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



IVF/GYN Procedure 594 160.5 198 0.60358.5

Laser Eye 0 0 0 0.0000

of 292 2/7/2020


Western Diversey Surgical Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 196

2546137180

703

261525725

0

899




TOTAL 196

000

255448

0

703

000

447452

0

899




00 0 971,408 360,571 1,331,979

0.0%0.0% 0.0% 72.9% 27.1%


0

Charity Care

Expense

0%



Reference Numbers

006

7003183

030

Western Diversey Surgical Center

2744 N. Western Avenue

Chicago, IL 60647

Administrator

Julie Swanson


Registered Agent

John Boland

Property Owner

Renlin Xia, M.D.

Legal Owner(s)

Facility Id



Sophia Demas 773 772-7726




Exam Rooms 2

Procedure Rooms 0



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Noweigian American Hospital 0




Exam Rooms 2

Procedure Rooms 0

Renlin Xia, M.D.

of 292 2/7/2020


Western Diversey Surgical Center ChicagoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


487.50 454.25TOTAL 899 941.75 1.05















60155 COOK 16Broadview












PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Advantage Health Care, ltd Wood DaleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 6

20793

800

821

2079611

00

827




TOTAL 6

000

190335296

821

000

195336296

827




00 0 347,279 401,156 748,435

0.0%0.0% 0.0% 46.4% 53.6%


207,200

Charity Care

Expense

28%



Reference Numbers

007

7002140

043

Advantage Health Care, ltd

203 E Irving Park Rd

Wood Dale, IL 60191

Administrator

Nancy Nelson


Registered Agent

State Registry Ltd

Property Owner

Arizona

Legal Owner(s)

Facility Id



Vera Schmidt 847-255-7400




Exam Rooms 2

Procedure Rooms



TOTAL 14.00

STAFFING PATTERNS



Type of Ownership




Advocate Lutheran Hospital 0




Exam Rooms 2

Procedure Rooms

Advantage Health Care Ltd

of 292 2/7/2020


Advantage Health Care, ltd Wood DaleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


620.25 827.00TOTAL 827 1447.25 1.75

60101 Cook 40Addison

60106 Cook 23Bensenville

60110 Kane 21Carpentersville

60107 Cook 21Bartlett

60133 Cook 20Hanover Park

60191 Dupage 18Wood Dale


60085 Lake 17Waukegan

60139 Dupage 17Glendale Heights

60169 Cook 16Hoffman Estates


60123 Kane 16Elgin

60120 Kane 15Elgin

60164 Cook 14Melrose Park

60008 Cook 13Rolling Meadows

60056 Dupage 12Mount Prospect


60126 Kane 10Elmhurst


60103 Dupage 9Bartlett

60007 Cook 9Elk Grove Village

60148 Dupage 9Lombard

60099 McHenry 9Zion




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Aiden Center for Day Surgery, LLC AddisonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 65

2139128303

302

916215338

5

367




TOTAL 65

0310

136135

0

302

0370

166164

0

367




064,307 0 1,263,517 180,039 1,507,863

0.0%4.3% 0.0% 83.8% 11.9%


0

Charity Care

Expense

0%



Reference Numbers

007

7003140

043

Aiden Center for Day Surgery, LLC

1580 W. Lake St.

Addison, IL 60101

Administrator

Ali Nili


Registered Agent

Paul Gilman

Property Owner

Legal Owner(s)

Facility Id



Alfonso del Granado 630-447-8254




Exam Rooms 0

Procedure Rooms 0



TOTAL 6.58

STAFFING PATTERNS



Type of Ownership




Alexian Brothers MC, Elk Grove Village 0Central DuPage Hosp, Winfield 0




Exam Rooms 0

Procedure Rooms 0

Kianoosh Jafari, MD

of 292 2/7/2020


Aiden Center for Day Surgery, LLC AddisonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


590.25 95.00TOTAL 367 685.25 1.87

60047 LAKE 20Lake Zurich

60010 LAKE 11Barrington

60103 COOK 10Bartlett


99999 8

60191 DUPAGE 7Wood Dale

60108 DUPAGE 7Bloomingdale


60123 KANE 7Elgin

60050 MCHENRY 5Mc Henry

60172 DUPAGE 5Roselle

60014 MCHENRY 5Crystal Lake

60013 MCHENRY 5Cary

60102 McHenry 5Algonquin


60101 DUPAGE 5Addison


60484 WILL 4University Park

60004 COOK 4Arlington Heights

60110 KANE 4Carpentersville

60188 DUPAGE 3Wheaton

60051 MCHENRY 3McHenry

60084 LAKE 3Wauconda




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Ambulatory Surgicenter of Downers Grove Downers GroveAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 32

07739300

866

0791106

10

898




TOTAL 32

000

698168

0

866

000

723175

0

898




00 0 1,717,600 402,894 2,120,494

0.0%0.0% 0.0% 81.0% 19.0%


0

Charity Care

Expense

0%



Reference Numbers

007

7002082

043

Ambulatory Surgicenter of Downers Grove

4333 Main Street

Downers Grove, IL 60515

Administrator

Inga Ferdkoff


Registered Agent

Amos E Madanes, M.D.

Property Owner

4339 Main LLC

Legal Owner(s)

Facility Id



Santa Ramos 630-322-9451




Exam Rooms 1

Procedure Rooms 1



TOTAL 11.00

STAFFING PATTERNS



Type of Ownership




Good Samaritan, Downers Grove 0




Exam Rooms 1

Procedure Rooms 1

of 292 2/7/2020


Ambulatory Surgicenter of Downers Grove Downers GroveAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


493.90 314.30TOTAL 898 808.20 0.90

60515 DU PAGE 24Downers Grove



46307 Lake 22

46307 LAKE 22


60505 KANE 16Aurora

46368 Porter 16

46410 Lake 16

60804 COOK 16Cicero

46368 PORTER 16

46410 LAKE 16

60438 COOK 15Lansing

60402 COOK 14Berwyn

60181 DU PAGE 14Villa Park

60101 OUPAGE 12Addison

60502 DU PAGE 12Aurora



46319 Lake 11

60423 WILL 11Frankfort

46319 LAKE 11


46303 LAKE 10



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Ashton Center for Day Surgery Hoffman EstatesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,098

2291628139110

1,170

3646

1,159264196

2,268




TOTAL 1,098

1269

0487413

0

1,170

1458

0904905

0

2,268




0239,484 0 9,308,352 361,100 9,908,936

0.0%2.4% 0.0% 93.9% 3.6%


0

Charity Care

Expense

0%



Reference Numbers

007

7003138

031

Ashton Center for Day Surgery

1800 McDonough Rd., Ste . 100

Hoffman Estates, IL 60192

Administrator

Alfonso del Granado


Registered Agent

Paul Gilman

Property Owner

Legal Owner(s)

Facility Id







Exam Rooms 1

Procedure Rooms 0



TOTAL 16.50

STAFFING PATTERNS



Type of Ownership




St. Alexius MC, Hoffman Estates 6




Exam Rooms 1

Procedure Rooms 0

Ankur Chhadia, MD

Dmitri Novoseletsky, MD

Howard Freedberg, MD

Kianoosh Jafari, MD

of 292 2/7/2020


Ashton Center for Day Surgery Hoffman EstatesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


900.75 488.75TOTAL 2268 1389.50 0.61


60123 KANE 118Elgin


60120 KANE 111Elgin


60133 DUPAGE 64Hanover Park



60124 KANE 55Elgin

60177 KANE 54South Elgin

60142 MCHENRY 53Huntley

60102 McHenry 52Algonquin

60193 COOK 43Roselle

60140 MCHENRY 41Hampshire

60185 DUPAGE 39West Chicago

60169 COOK 38Hoffman Estates

60118 KANE 33Dundee

60007 COOK 33Elk Grove Village


60194 COOK 28Schaumburg

99999 27

60156 LAKE 27Lake in the Hills





PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Associated Surgical Center, LLC Arlington HeightsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 466

092

20810853

461

122142418299

927




TOTAL 466

37172

5201433

461

54286

25459

985

927




24,533138,887 83,565 519,850 223,048 989,883

2.5%14.0% 8.4% 52.5% 22.5%


14,939

Charity Care

Expense

2%



Reference Numbers

007

7003214

031

Associated Surgical Center, LLC

129 W Rand Road, Suite 1

Arlington Heights, IL 60004-3124

Administrator

Mark Mayo, CASC


Registered Agent

James M. Sulzer

Property Owner

Rand Road Center

Legal Owner(s)

Facility Id



Mark Mayo, CASC 847-565-0530




Exam Rooms 1

Procedure Rooms 0



TOTAL 7.25

STAFFING PATTERNS



Type of Ownership




St. Alexius Med Ctr, Hoffman Estates 0Advocate Condell Hospital, Libertyville 0Holy Family Med Ctr, Des Plaines 0Glenbrook Hospital, Glenview 1




Exam Rooms 1

Procedure Rooms 0

Yelena Levitin, MD

of 292 2/7/2020


Associated Surgical Center, LLC Arlington HeightsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


723.00 435.00TOTAL 927 1158.00 1.25

60090 115Wheeling

60074 61Palatine

60089 51Buffalo Grove

60016 42Des Plaines

60056 34Mount Prospect

60004 31Arlington Heights

60061 25Vernon Hills

60120 24Elgin


60018 24Des Plaines

60025 23Glenview

60073 21Round Lake

60060 17Mundelein

60062 17Northbrook

60047 17Lake Zurich

60070 16Prospect Heights

60193 14Roselle

60123 13Elgin

60008 12Rolling Meadows

60110 11Carpentersville

60015 11Deerfield

60714 10Niles

60169 10Hoffman Estates

60107 10Bartlett



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Cadence Ambulatory Surgical Center WarrenvilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,959

41499

1,030477396

2,443

901,0641,841

822585

4,402




TOTAL 1,959

190886129

1,2193

16

2,443

3541,370

3332,313

824

4,402




281,0371,254,725 3,084,295 5,865,207 23,783 10,509,047

2.7%11.9% 29.3% 55.8% 0.2%


78,741

Charity Care

Expense

1%



Reference Numbers

007

7003173

043

Cadence Ambulatory Surgical Center

27650 Ferry Road, Suite 140

Warrenville, IL 60555

Administrator

Maura O'Toole


Registered Agent

Danae K. Prousis

Property Owner

Legal Owner(s)

Facility Id



Bryan Foster 815-759-8026




Exam Rooms 0

Procedure Rooms 0



TOTAL 20.66

STAFFING PATTERNS



Type of Ownership




Central DuPage Hospital 3




Exam Rooms 0

Procedure Rooms 0

of 292 2/7/2020


Cadence Ambulatory Surgical Center WarrenvilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


3,089.60 1,501.60TOTAL 4402 4591.20 1.04




60137 DUPAGE 251Glen Ellyn


60190 DUPAGE 155Winfield

60555 DUPAGE 146Warrenville

60563 DUPAGE 129Naperville

60103 DUPAGE 124Bartlett


60174 KANE 110St. Charles

60510 KANE 102Batavia

60139 DUPAGE 99Glendale Heights


60148 DUPAGE 91Lombard

60134 KANE 88Geneva

60506 KANE 74Aurora



60505 KANE 63Aurora


60564 WILL 59Naperville

60532 DUPAGE 58Lisle




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Center for Reconstructive Surgery Oak LawnAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 797

243

288429295

1,057

5107504706532

1,854




TOTAL 796

590221

0217300

1,058

964386

0432

720

1,854




-10,4031,240,255 0 1,207,159 183,095 2,620,106

-0.4%47.3% 0.0% 46.1% 7.0%


3,009

Charity Care

Expense

0%



Reference Numbers

007

7002843

031

Center for Reconstructive Surgery

6311 West 95th. Street

Oak Lawn, IL 60453

Administrator

Jeannie Rochon


Registered Agent

Kelly Whelan

Property Owner

Legal Owner(s)

Facility Id



Jo Ann DePergola 708-499-3355




Exam Rooms 0

Procedure Rooms 0


Director of NursesRegistered NursesCertified AidesOther Health Profs.Other Non-Health Profs

TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Little Company of Mary Hospital 0




Exam Rooms 0

Procedure Rooms 0

CFRA Limited

Dr. L. Sidrys

Dr. S. Bhatia

NovaMed Aquisition

of 292 2/7/2020


Center for Reconstructive Surgery Oak LawnAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


681.00 441.00TOTAL 1854 1122.00 0.61

60453 cook 203Oak Lawn



60805 cook 72Evergreen Park


60462 cook 70Orland Park


60459 cook 59Burbank

60423 will 59Frankfort

60465 cook 51Palos Hills

60463 cook 50Palos Heights

60477 cook 48Tinley Park



60457 cook 40Hickory Hills

60467 cook 40Orland Park

60803 cook 39Alsip

60452 cook 37Oak Forest

60455 cook 33Oak Lawn


60491 will 29Homer Glen

60482 cook 29Worth

60415 cook 27Chicago Ridge




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Chicago Prostate Cancer Surgery Center, LLC WestmonyAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 573

00000

0

02

22225792

573




TOTAL 573

000000

0

0222

5346

00

573




0814,609 27,267 1,366,973 88,960 2,297,809

0.0%35.5% 1.2% 59.5% 3.9%


0

Charity Care

Expense

0%



Reference Numbers

007

7003098

043

Chicago Prostate Cancer Surgery Center, LLC

815 Pasquinelli Drive

Westmony, IL 60559

Administrator

Jennifer T. White


Registered Agent

Jennifer T White

Property Owner

Quasar, LLC

Legal Owner(s)

Facility Id



Jennifer T. White 630-654-2515




Exam Rooms 0

Procedure Rooms 0



TOTAL 11.00

STAFFING PATTERNS



Type of Ownership

Sole Proprietorship



Amita Health-Hinsdale Hospital 0




Exam Rooms 0

Procedure Rooms 0

Brian J. Moran, M.D.

of 292 2/7/2020


Chicago Prostate Cancer Surgery Center, LLC WestmonyAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


286.50 286.50TOTAL 573 573.00 1.00

60402 18Berwyn

60126 17Elmhurst

60565 16Naperville

60564 13Naperville

60181 12Villa Park

60516 11Downers Grove

60148 10Lombard

60137 10Glen Ellyn

60629 8Chicago

60540 8Naperville

60193 8Roselle

60101 8Addison

60638 7Chicago


60154 6Westchester

60532 6Lisle

60585 6Plainfield

60439 6Lemont

60194 6Schaumburg

60153 6Maywood

60143 5Itasca

60517 5Woodridge

60525 5La Grange

60441 5Lockport



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Chicago Vascular ASC, LLC WestmontAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 349

019729680

267

048

210206152

616




TOTAL 349

21237

5040

267

40552

17070

616




00 0 0 0 0



0

Charity Care

Expense

0%



Reference Numbers

007

7003219

043

Chicago Vascular ASC, LLC

700 Pasquinelli Drive

Westmont, IL 60559

Administrator

Deborah Cusack


Registered Agent


Property Owner

GM Holdings, LLC

Legal Owner(s)

Facility Id



Rhonda Palumbo 610-644-8900




Exam Rooms 1

Procedure Rooms 3



TOTAL 25.60

STAFFING PATTERNS



Type of Ownership




Advocate Good Samaritan Hospital, Downers Grove 0




Exam Rooms 1

Procedure Rooms 3

Angelo Makris, MD

of 292 2/7/2020


Chicago Vascular ASC, LLC WestmontAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

60505 Kane 43Aurora

60506 Kane 25Aurora


60085 Lake 19Waukegan


60560 Kendall 13Yorkville


60538 Kendall 12Montgomery




60504 Dupage 10Aurora


60632 Cook 9Chicago

60543 Kendall 9Oswego

60073 Lake 8Round Lake

60623 Cook 8Chicago

60624 Cook 8Chicago

60548 Dekalb 8Sandwich

60153 Cook 8Maywood

60174 Kane 8St. Charles

60433 Will 8Joliet

60478 Cook 8Country Club Hills

60542 Kane 7North Aurora



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Children's Outpatient Services at Westchester WestchesterAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018

0-14 years 1,27615-44 years 11645-64 years 065-74 years 075+ years 0

TOTAL 1,392

809100

000

909

2,085216

000

2,301




TOTAL 1,392

30607

5811

14

909

7610

291,472

138

2,301




769,7980 100,059 10,452,740 12,512 11,335,109

6.8%0.0% 0.9% 92.2% 0.1%


15,815

Charity Care

Expense

0%



Reference Numbers

007

7001555

031

Children's Outpatient Services at Westchester

2301 Enterprise Drive

Westchester, IL 60154

Administrator

Patricia Farrell


Registered Agent

Property Owner

Legal Owner(s)

Facility Id



Patricia Farrell 312-227-4316




Exam Rooms 0

Procedure Rooms 0



TOTAL 22.64

STAFFING PATTERNS



Type of Ownership




LaGrange Hospital, LaGrange, IL 0




Exam Rooms 0

Procedure Rooms 0

Ann & Robert H. Lurie Children's Hospital

of 292 2/7/2020


Children's Outpatient Services at Westchester WestchesterAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,555.50 986.67TOTAL 2301 3542.17 1.54

60525 Cook 41La Grange

60451 Will 39New Lenox

60126 Du Page 39Elmhurst


60586 Will 31Plainfield

60505 Kane 31Aurora

60435 Will 30Joliet

60521 Du Page 28Hinsdale

60137 Du Page 28Glen Ellyn

60440 Will 25Bolingbrook

60441 Will 25Lockport

60134 Kane 25Geneva

60189 Du Page 25Wheaton

60558 Cook 24Western Springs


60446 Will 22Romeoville


60564 Will 21Naperville

60513 Cook 21Brookfield

60565 Du Page 20Naperville



60432 Will 19Joliet

60804 Cook 18Cicero



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


DMG Surgical Center, LLC LombardAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018

0-14 years 73915-44 years 1,69345-64 years 4,44865-74 years 3,41675+ years 1,655

TOTAL 11,951

3662,1245,4733,5971,913

13,473

1,1053,8179,9217,0133,568

25,424




TOTAL 11,951

03,982

09,491

00

13,473

07,314

018,110

00

25,424




06,552,880 0 31,884,977 0 38,437,857

0.0%17.0% 0.0% 83.0% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

007

7003023

043

DMG Surgical Center, LLC

2725 Technology Drive

Lombard, IL 60148

Administrator

Donna Cooper


Registered Agent

Jennifer Groszek

Property Owner

Harrison Street RE

Legal Owner(s)

Facility Id



Rita Meyer 630-942-7964




Exam Rooms 14

Procedure Rooms 3



TOTAL 115.35

STAFFING PATTERNS



Type of Ownership




Advocate Good Samaritan Hospital, Downers Grove




Exam Rooms 14

Procedure Rooms 3

DuPage Medical Group

Edward Hospital

of 292 2/7/2020


DMG Surgical Center, LLC LombardAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.000 0.00 0.00General 2,462.00 721.252885 3183.25 1.10Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 420.75 142.50570 563.25 0.99Ophthalmology 1,426.25 681.502725 2107.75 0.77Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 2,816.15 707.002827 3523.15 1.25Otolaryngology 1,664.50 405.301621 2069.80 1.28Pain Management 409.25 440.501762 849.75 0.48Plastic Surgery 1,074.00 156.25624 1230.25 1.97Podiatry 348.25 81.50325 429.75 1.32Thoracic 0.00 0.000 0.00 0.00Urology 1,458.50 369.501478 1828.00 1.24

12,079.65 3,705.30TOTAL 14817 15784.95 1.07

60148 1546Lombard

60137 1223Glen Ellyn

60188 935Wheaton

60540 877Naperville

60189 838Wheaton



60565 748Naperville

60187 741Wheaton

60532 648Lisle

60564 639Naperville

60126 638Elmhurst

60517 618Woodridge

60563 587Naperville

60181 568Villa Park

60185 548West Chicago

60103 521Bartlett

60559 468Westmont

60139 449Glendale Heights

60561 440Darien

60108 436Bloomingdale

60440 423Bolingbrook

60527 423Willowbrook

60101 355Addison



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


DuPage Eye Surgery Center, LLC WheatonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018

0-14 years 115-44 years 21445-64 years 1,08165-74 years 1,53575+ years 1,506

TOTAL 4,337

1198

1,3102,2982,125

5,932

2412

2,3913,8333,631

10,269




TOTAL 4,337

103,238

02,448

16076

5,932

295,396

04,375

333136

10,269




20,7075,475,579 0 7,117,178 773,732 13,387,196

0.2%40.9% 0.0% 53.2% 5.8%


220,119

Charity Care

Expense

2%



Reference Numbers

007

7003121

043

DuPage Eye Surgery Center, LLC

2015 North Main Street

Wheaton, IL 60187

Administrator

Charles S. Sandor


Registered Agent

Charles S. Sandor, MD

Property Owner

2015 Realty

Legal Owner(s)

Facility Id



Samantha D. Cooper 630-665-3690




Exam Rooms

Procedure Rooms 2



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Northwestern Medicine Central DuPage Hospital 2




Exam Rooms

Procedure Rooms 2

Anna J. Park, MD

Charles S. Sandor, MD

Edward D. Sung, MD

eremy B. Wingard, MD

Gregory L. Fenton, MD

Janet A. Lee, MD

Jon P. Gieser, MD

Mary G. Mehaffey, MD

Michael A. Kipp, MD

Michelle E. Andreoli, MD

Michelle G. Sims, MD

Noha Ekdawi, MD

Ruth D. Williams, MD

Steven R. Lafayette, MD

Susan Anderson-Nelson,M

Terry Voirin, DO

Thomas S. Michelson, MD

Vikram Setlur, MD

of 292 2/7/2020


DuPage Eye Surgery Center, LLC WheatonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,879.00 785.58TOTAL 7849 2664.58 0.34














60190 DUPAGE 195Winfield




60555 DUPAGE 153Warrenville

60532 DUPAGE 153Lisle

60544 WILL 148Plainfield

60134 KANE 148Geneva



60506 KANE 129Aurora



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 2420 121 241.32 0.15362.322


of 292 2/7/2020


Elmhurst Outpatient Surgery Center ElmhurstAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 3,364

46488

1,4681,114

845

3,961

135969

2,7812,0231,417

7,325




TOTAL 3,364

01,856

52,082

180

3,961

03,182

74,085

510

7,325




02,376,508 7,935 7,569,137 91,506 10,045,086

0.0%23.7% 0.1% 75.4% 0.9%


0

Charity Care

Expense

0%



Reference Numbers

007

7002330

043

Elmhurst Outpatient Surgery Center

1200 S York Road Suite 1400

Elmhurst, IL 60126

Administrator

Julia Nelson


Registered Agent

Julia Nelson

Property Owner

Elmhurst Hospital

Legal Owner(s)

Facility Id



Julia Nelson 630-758-8801




Exam Rooms 0

Procedure Rooms 4



TOTAL 41.50

STAFFING PATTERNS



Type of Ownership




Elmhurst Memorial Hospital, Elmhurst 5




Exam Rooms 0

Procedure Rooms 4

Andrew Belavic MD

Balaji Gupta MD

Christine Kassa MD

Christopher Boutin, MD

Elmhurst Memorial Hospital

George Fikaris MD

George Stathopoulos MD

Gordon Kinzler MD

Harry Siavelis MD

John Giradot MD

John Hamby MD

John Ortega MD

Juozas Gurevicius MD

Kerri A Kulovitz, DO

Mark Spaccapaniccia DPM

Meena George, MD

Michael Less MD

Michael Martirano MD

Nabil Barakat MD

Petras Kisielius MD

S. Dharan Kumar, MD

Salil Doshi MD

Savan Patel MD

of 292 2/7/2020


Elmhurst Outpatient Surgery Center ElmhurstAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,671.90 2,241.00TOTAL 2520 4912.90 1.95



60181 DuPage 403Villa Park

60101 DuPage 347Addison

60106 DuPage 286Bensenville


60191 DuPage 181Wood Dale

60104 Cook 130Bellwood

60154 Cook 127Westchester


60131 Cook 117Franklin Park

60162 Cook 113Hillside

60523 DuPage 112Oak Brook

60137 DuPage 98Glen Ellyn


60139 DuPage 97Glendale Heights


60108 DuPage 91Bloomingdale

60527 DuPage 78Willowbrook

60440 DuPage 67Bolingbrook

60402 Cook 66Berwyn

60525 DuPage 62La Grange

60561 DuPage 61Darien

60188 DuPage 61Wheaton



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE


Eye Room 1341 790.75 670.5 1.091461.25


Laser Eye 100 50 75 1.251251

of 292 2/7/2020


Elmwood Park Same Day Surgery Center Elmwood ParkAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 135

0487730

128

099

15590

263




TOTAL 135

0000

1280

128

0000

2630

263




00 0 1,303,815 0 1,303,815

0.0%0.0% 0.0% 100.0% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

007

7003182

031

Elmwood Park Same Day Surgery Center

1614 North Harlem Avenue

Elmwood Park, IL 60707

Administrator

Scott Borre


Registered Agent

Edward J. Green

Property Owner

Hugar Building Partnshp

Legal Owner(s)

Facility Id



Janelle Jankowski 847-448-4717




Exam Rooms 0

Procedure Rooms 0



TOTAL 12.00

STAFFING PATTERNS



Type of Ownership




Gottlieb Memorial Hospital, Melrose Park,IL 0




Exam Rooms 0

Procedure Rooms 0

Scott Borre

of 292 2/7/2020


Elmwood Park Same Day Surgery Center Elmwood ParkAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


86.00 51.00TOTAL 263 137.00 0.52

60628 13Chicago

60827 12Riverdale

60619 9Chicago

60644 8Chicago

60620 8Chicago

60629 7Chicago

60473 7South Holland

60652 6Chicago

60804 6Cicero

60649 5Chicago

60440 5Bolingbrook


60656 4Harwood Heights

60632 4Chicago

60637 4Chicago

60617 4Chicago

60402 4Berwyn

60443 4Matteson

60643 4Chicago

60131 3Franklin Park

60201 3Evanston

60154 3Westchester

60477 3Tinley Park

60181 3Villa Park



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Eye Surgery Center of Hinsdale HinsdaleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 321

00

42806945

1,793

02

125904

1,083

2,114




TOTAL 321

21,510

0263180

1,793

31,731

0351

272

2,114




0942,000 0 1,100,000 24,750 2,066,750

0.0%45.6% 0.0% 53.2% 1.2%


2,500

Charity Care

Expense

0%



Reference Numbers

007

7002942

043

Eye Surgery Center of Hinsdale

950 North York Road

Hinsdale, IL 60521

Administrator

Brian D Smith, MD


Registered Agent

Brian Smith, M.D.

Property Owner

950 N York Hinsdale

Legal Owner(s)

Facility Id



Brian D Smith, MD 630-789-6700




Exam Rooms 0

Procedure Rooms 1



TOTAL 10.00

STAFFING PATTERNS



Type of Ownership




Hinsdale Hospital, Hinsdale 0




Exam Rooms 0

Procedure Rooms 1

of 292 2/7/2020


Eye Surgery Center of Hinsdale HinsdaleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


572.00 312.00TOTAL 884 884.00 1.00


60525 COOK 244La Grange

60521 DUPAGE 143Hinsdale

60558 COOK 120Western Springs

60400 115

60154 COOK 105Westchester

60514 DUPAGE 85Clarendon Hills

60100 82

60500 73


60523 DUPAGE 65Oak Brook


50561 DUPAGE 63



60600 COOK 52

60000 46

60526 COOK 37LaGrange Park



60559 DUPAGE 29Westmont

60513 COOK 26Brookfield

60517 DUPAGE 22Woodridge




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Intra-Vitreal Inject 956 16 554 0.60570

Laser Eye 274 71 182 0.922531

of 292 2/7/2020


Golf Surgical Center Des PlainesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,645

220327859875943

3,224

501694

1,5481,5221,604

5,869




TOTAL 2,645

241,647

41,535

130

3,223

442,789

342,970

310

5,868




9792,792,646 244,499 6,685,764 146,719 9,870,607

0.0%28.3% 2.5% 67.7% 1.5%


3,221

Charity Care

Expense

0%



Reference Numbers

007

7002231

031

Golf Surgical Center

8901 Golf Road

Des Plaines, IL 60016

Administrator

Michelle Kirkman


Registered Agent

Corporate Creations Internatio

Property Owner

GA HC REIT II

Legal Owner(s)

Facility Id



Michelle Kirkman 847-321-6698




Exam Rooms 0

Procedure Rooms 2



TOTAL 42.00

STAFFING PATTERNS



Type of Ownership




Advocate Lutheran General Hospital 1




Exam Rooms 0

Procedure Rooms 2

Advocate Network Service

ASTC Services, Ltd

Surgical Care Affiliates

of 292 2/7/2020


Golf Surgical Center Des PlainesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,944.24 0.00TOTAL 4579 1944.24 0.42

60068 569Park Ridge

60016 549Des Plaines

60714 363Niles


60053 212Morton Grove


60631 211Chicago

60025 154Glenview



60634 131Norridge

60062 119Northbrook

60646 114Chicago

60630 110Chicago



60090 88Wheeling

60015 73Deerfield


60077 64Skokie

60076 62Skokie

60074 57Palatine


60067 56Palatine



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



General Surgery 213 80.5 0.00

Laser Eye 922 82 0 0.09821

of 292 2/7/2020


Hinsdale Surgical Center HinsdaleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,443

46508

1,193950858

3,555

111873

1,9881,6241,402

5,998




TOTAL 2,443

181,939

01,438

1600

3,555

293,171

02,580

2180

5,998




-16,2034,582,545 -468 7,355,146 314,814 12,235,834

-0.1%37.5% 0.0% 60.1% 2.6%


0

Charity Care

Expense

0%



Reference Numbers

007

7003198

043

Hinsdale Surgical Center

10 Salt Creek Lane

Hinsdale, IL 60521

Administrator

Brenna Fazio


Registered Agent


Property Owner

Salt Creek Campus LLC

Legal Owner(s)

Facility Id



Brenna Fazio 630-325-5035




Exam Rooms 0

Procedure Rooms 2



TOTAL 52.00

STAFFING PATTERNS



Type of Ownership




Adventist Hinsdale Hospital, Hinsdale 9




Exam Rooms 0

Procedure Rooms 2

Amy Vandenbrook, MD

David Burt, MD

Dwight Kett, MD

Erling Ho, MD

Ira Goodman, MD

James Noth, MD

Jesse Wardlow, MD

John Hong, MD

John Kris_tas, MD

John Nikoleit, MD

Kevin Salvino, DPM

Kimberly Napolitano, MD

Michael Bercek, MD

Neena Will

Neha Iyengar

Nicholas Anderson, DPM

Robert Thomas, MD

Samuel Girgis , MD

Scott Glaser, MD

Scott Seymour, MD

Sophia Sar kos, MD

Stephen Kraseman MD

Tripti Burt, MD

of 292 2/7/2020


Hinsdale Surgical Center HinsdaleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


4,034.46 1,612.52TOTAL 5998 5646.98 0.94



60516 DuPage 268Downers Grove

60561 DuPage 254Darien

60521 DuPage 211Hinsdale

60515 DuPage 204Downers Grove

60559 DuPage 190Westmont


60514 DuPage 123Clarendon Hills

60439 Cook 120Lemont

60517 DuPage 119Woodridge

60532 DuPage 114Lisle




60402 Cook 94Berwyn

60526 Cook 86LaGrange Park




60565 DuPage 69Naperville


60467 Cook 65Orland Park




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Hoffman Estates Surgery Center, LLC Hoffman EstatesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,447

23249803

1,223855

3,153

116430

1,4942,0821,478

5,600




TOTAL 2,447

331,634

01,463

194

3,153

442,766

02,740

4010

5,600




2,4653,581,936 0 5,753,484 22,863 9,360,748

0.0%38.3% 0.0% 61.5% 0.2%


4,982

Charity Care

Expense

0%



Reference Numbers

007

7003122

031

Hoffman Estates Surgery Center, LLC

1555 Barrington Road Suite 400

Hoffman Estates, IL 60169

Administrator

Annamarie C. York


Registered Agent


Property Owner

HRT

Legal Owner(s)

Facility Id



Annamarie C. York 847-519-1600




Exam Rooms 0

Procedure Rooms 2



TOTAL 32.00

STAFFING PATTERNS



Type of Ownership




St. Alexius Medical Center, Hoffman Estates 4




Exam Rooms 0

Procedure Rooms 2

Abraham Mathew, MD

Asad Aziz, MD

Bradley Shapiro, MD

Brian Muska, MD

Brooke Belcher, MD

Bruce Lindgren, MD

Ciro Cirrincione, MD

Deepak Khurana, MD

Erwin Szela, MD

George Zahrebelski, MD

Gregory Nelson, MD

Jason Rotstein, MD

Jeffery Jagmin, MD

Keith Komnick, MD

Keith Schroeder, MD

Kevin Sullivan, MD

Kimberlee Curnyn, MD

Maria Rosselson, MD

Mark Cabin, MD

Mark Dubin, MD

Mark Piotrowski, MD

Mark Rosanova, MD

Mark Yaffe, MD

of 292 2/7/2020


Hoffman Estates Surgery Center, LLC Hoffman EstatesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,984.16 1,970.55TOTAL 4564 3954.71 0.87









60133 COOK 188Hanover Park


60142 MCHENRY 146Huntley

60120 KANE 140Elgin

60102 MCHENRY 133Algonquin




60143 DUPAGE 85Itasca



60118 KANE 80Dundee







PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Illinois Hand & Upper Extremity Center Arlington HeighhtsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 474

072

119101

202

027537028

3

676




TOTAL 474

000

19840

202

000

66880

676




00 0 1,765,000 16,231 1,781,231

0.0%0.0% 0.0% 99.1% 0.9%


0

Charity Care

Expense

0%



Reference Numbers

007

7003165

031

Illinois Hand & Upper Extremity Center

515 W Algonquin Road

Arlington Heighhts, IL 60005

Administrator

Donna Kersting


Registered Agent

Richard Weil

Property Owner

ALGO, LLC

Legal Owner(s)

Facility Id



Donna Kersting 847-956-0099




Exam Rooms 0

Procedure Rooms 0



TOTAL 7.00

STAFFING PATTERNS



Type of Ownership




Northwest Community Hospital 3




Exam Rooms 0

Procedure Rooms 0

Hand Surgery Assoc

Michael I Vender

Prasant Atluri, MD

Sam J Biafgora

Scott D Sagerman

of 292 2/7/2020


Illinois Hand & Upper Extremity Center Arlington HeighhtsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


872.00 329.00TOTAL 676 1201.00 1.78


60123 KANE 12Elgin

60101 DU PAGE 12Addison


60120 KANE 11Elgin


60505 KANE 10Aurora






60139 DU PAGE 8Glendale Heights



60639 COOK 7Chicago

60804 COOK 7Cicero


60106 DU PAGE 7Bensenville

60181 DU PAGE 7Villa Park

60008 COOK 7Rolling Meadows

60506 KANE 7Aurora

60193 COOK 7Roselle

60623 COOK 6Chicago



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Illinois Sports Medicine & Orthopedic Surgery Cen Morton GroveAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,709

41322

1,101420328

2,212

81735

1,843754508

3,921




TOTAL 1,709

0855

21,334

210

2,212

01,346

62,532

370

3,921




01,358,525 1,942,333 8,947,228 160,037 12,408,123

0.0%10.9% 15.7% 72.1% 1.3%


0

Charity Care

Expense

0%



Reference Numbers

007

7003118

031

Illinois Sports Medicine & Orthopedic Surgery Cent

9000 Waukegan Road, Suite 120

Morton Grove, IL 60053

Administrator

Lawrence J. Parrish


Registered Agent

David J. Raab, MD

Property Owner

CMK 9000 Waukegan

Legal Owner(s)

Facility Id



Lawrence J. Parrish 847-213-5455




Exam Rooms 8

Procedure Rooms 1



TOTAL 31.00

STAFFING PATTERNS



Type of Ownership




Advocate Lutheran General Hospital 5




Exam Rooms 8

Procedure Rooms 1

Alan League, MD

Alexander Goldin, MD

Alexander Gordon, MD

Andrea Kramer, MD

Brian Clay, MD

Craig Williams, MD

David Raab, MD

David Tojo, MD

Douglas Solway, DPM

Garo Emerzian, DPM

Gary Friend, DPM

Henry Kurzydlowski, MD

Howard Stone, DPM

Ira Goodman, MD

James Bresch, MD

Jeffrey Visotsky, MD

Kathryn Grace, DPM

Marc Breslow, MD

Matthew Jimenez, MD

Michael Layland, MD

Rajeev Garapati, MD

Richard Noren, MD

Ritesh Shah, MD

of 292 2/7/2020


Illinois Sports Medicine & Orthopedic Surgery Cen Morton GroveAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,587.75 963.00TOTAL 2677 3550.75 1.33

60068 222Park Ridge



60062 167Northbrook

60035 136Highland Park

60714 125Niles

60631 120Chicago




60025 107Glenview

60015 104Deerfield


60634 74Norridge

60090 72Wheeling

60646 72Chicago

60630 65Chicago


60077 57Skokie

60030 52Grayslake

60091 50Wilmette

60047 50Lake Zurich

60076 47Skokie

60074 44Palatine



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000

Pain Management 1244 419.75 24.5 0.36444.251

of 292 2/7/2020


Ingalls Same Day Surgery Tinley ParkAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,440

18340724506423

2,011

35556

1,232864764

3,451




TOTAL 1,440

0910

0841259

1

2,011

01,590

01,573

2871

3,451




02,045,280 0 2,049,961 187,349 4,282,590

0.0%47.8% 0.0% 47.9% 4.4%


1,696

Charity Care

Expense

0%



Reference Numbers

007

7001043

031

Ingalls Same Day Surgery

6701 West 159th Street

Tinley Park, IL 60477

Administrator

Joseph Ollayos


Registered Agent


Property Owner

Ingalls Health Ventures

Legal Owner(s)

Facility Id



Kathleen Shepard 708-915-7430




Exam Rooms 0

Procedure Rooms 0



TOTAL 22.95

STAFFING PATTERNS



Type of Ownership




Ingalls Memorial Hospital, Harvey 2




Exam Rooms 0

Procedure Rooms 0

Antonio Mancini, DO

Charles Turk, DO

Daniel Weber, MD

David Dreyfuss, MD

David Raminski. MD

Ernesto Tan, MD

George Sreckovic, MD

Ingalls Health Ventures

Jack Gelman, MD

James Sylora, MD

John Grady, DPM

MedCentrix, Inc.

Michael Herzog, MD

Ram Aribindi MD

Robert Bosack, DDS

Steven Pierpaoli, MD

of 292 2/7/2020


Ingalls Same Day Surgery Tinley ParkAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,464.25 1,825.45TOTAL 3451 4289.70 1.24

60477 229Tinley Park

60462 181Orland Park


60423 148Frankfort

60452 130Oak Forest


60445 97Midlothian

60411 92Chicago Heights

60430 88Homewood

60448 84Mokena

60453 71Oak Lawn

60473 70South Holland

60491 66Homer Glen

60463 60Palos Heights

60451 59New Lenox

60464 58Palos Park

60655 57Chicago

60422 56Flossmoor

60438 53Lansing

60466 51Park Forest

60441 48Lockport

60409 47Calumet City

60443 47Matteson

60429 44Hazel Crest



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Justice Med-Surg, LTD JusticeAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 631

263

194124104

487

2121474306215

1,118




TOTAL 631

43235

0205

40

487

112537

0453

160

1,118




40,441778,211 921 1,455,232 115,263 2,390,068

1.7%32.6% 0.0% 60.9% 4.8%


3,000

Charity Care

Expense

0%



Reference Numbers

007

7002744

031

Justice Med-Surg, LTD

9050 W. 81st Street

Justice, IL 60458

Administrator

Susan Weyforth


Registered Agent

Brian O'Dea

Property Owner

First Step Holdings

Legal Owner(s)

Facility Id



Susan Weyforth 630-974-5291




Exam Rooms 1

Procedure Rooms 2



TOTAL 14.00

STAFFING PATTERNS



Type of Ownership




Palos Community Hospital, Palos Hills, IL




Exam Rooms 1

Procedure Rooms 2

Arthur Morris

Gregory Kozeny

Thomas Golubski

of 292 2/7/2020


Justice Med-Surg, LTD JusticeAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


261.00 136.50TOTAL 561 397.50 0.71



60462 COOK 55Orland Park


60477 COOK 39Tinley Park


60804 COOK 35Cicero


60491 WILL 29Homer Glen


60465 COOK 26Palos Hills

60439 COOK 26Lemont



60415 COOK 24Chicago Ridge

60458 COOK 23Justice


60459 COOK 20Burbank

60464 COOK 19Palos Park




60803 COOK 16Alsip




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Loyola Ambulatory Surgery Center at Oakbrook, L. Oakbrook TerraceAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 611

2117337513384

786

54350614220159

1,397




TOTAL 611

7020669

420210

786

105337197717

410

1,397




54,708345,674 1,533,021 2,721,054 96,812 4,751,269

1.2%7.3% 32.3% 57.3% 2.0%


656

Charity Care

Expense

0%



Reference Numbers

007

7002181

043

Loyola Ambulatory Surgery Center at Oakbrook, L.P.

1 South 224 Summit Avenue, Suite 201

Oakbrook Terrace, IL 60181

Administrator

Deb Gardiner


Registered Agent

CT Corporation

Property Owner

CMK2Oakbrook 224LLC

Legal Owner(s)

Facility Id



Sheryl McClement 630-916-7088




Exam Rooms 3

Procedure Rooms 0



TOTAL 13.00

STAFFING PATTERNS



Type of Ownership




Loyola University Med Ctr, Maywood 2Good Samaritan Hosp, Downers Grove 0Elmhurst Memorial Hosp, Elmhurst 0




Exam Rooms 3

Procedure Rooms 0

GT Lincolnwood Surg Ctr

Loyola Amb. Surg at Oakb

Loyola Ambulatory Ctrs

of 292 2/7/2020


Loyola Ambulatory Surgery Center at Oakbrook, L. Oakbrook TerraceAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


236.00 0.00TOTAL 331 236.00 0.71

60126 37Elmhurst

60525 32La Grange

60527 30Willowbrook

60402 28Berwyn

60181 28Villa Park

60638 27Chicago

60546 25Riverside

60153 24Maywood

60101 20Addison

60513 20Brookfield

60148 20Lombard

60154 19Westchester

60104 18Bellwood

60302 18Oak Park

60526 17LaGrange Park

60517 17Woodridge

60465 16Palos Hills

60440 15Bolingbrook

60453 15Oak Lawn

60491 14Homer Glen

60458 14Justice

60441 13Lockport

60130 13Forest Park

60561 13Darien



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Loyola University Ambulatory Surgery Center MaywoodAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,806

362805

1,104596404

3,271

9721,5211,8321,013

739

6,077




TOTAL 2,806

61690811

1,73600

3,271

1,2201,573

233,261

00

6,077




1,078,4963,102,199 185,793 16,697,816 1,106 21,065,410

5.1%14.7% 0.9% 79.3% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

007

7003164

031

Loyola University Ambulatory Surgery Center

2160 South First Avenue

Maywood, IL 60153

Administrator

Ella Echavez


Registered Agent

Property Owner

Legal Owner(s)

Facility Id



Steve Piniuta 708-216-7932




Exam Rooms 0

Procedure Rooms 0



TOTAL 42.00

STAFFING PATTERNS



Type of Ownership




Loyola University Medical Center, Maywood 40




Exam Rooms 0

Procedure Rooms 0

of 292 2/7/2020


Loyola University Ambulatory Surgery Center MaywoodAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 111.45 58.82173 170.27 0.98General 876.92 256.52755 1133.44 1.50Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 403.40 147.56433 550.96 1.27Ophthalmology 1,672.05 441.281507 2113.33 1.40Oral/Maxillofacial 225.60 40.80120 266.40 2.22Orthopedic 1,571.12 389.40885 1960.52 2.22Otolaryngology 1,790.22 416.161223 2206.38 1.80Pain Management 26.38 4.4213 30.80 2.37Plastic Surgery 358.92 90.10265 449.02 1.69Podiatry 111.02 26.1877 137.20 1.78Thoracic 0.00 0.000 0.00 0.00Urology 726.58 212.84626 939.42 1.50

7,873.66 2,084.08TOTAL 6077 9957.74 1.64

60402 Cook 220Berwyn

60153 Cook 170Maywood

60804 Cook 144Cicero




60546 Cook 127Riverside





60104 Cook 91Bellwood







60181 DuPage 65Villa Park

60155 Cook 65Broadview

60130 Cook 64Forest Park

60305 Cook 60River Forest





PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Lurie Chiledren's Surgery Center in Northbrook NorthbrookAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 0

00000

0

00000

0




TOTAL 0

000000

0

000000

0




00 0 0 0 0



0

Charity Care

Expense

0%



Reference Numbers

007

7003221

031

Lurie Chiledren's Surgery Center in Northbrook

1121 Techny Road

Northbrook, IL 60032

Administrator

Patricia Farrell


Registered Agent

Property Owner

Legal Owner(s)

Facility Id



Patricia Farrell 312-227-4316




Exam Rooms 0

Procedure Rooms 0



TOTAL 0.00

STAFFING PATTERNS



Type of Ownership




Glenbrook Hospital, Glenbrook, IL 0Northwest Community Hospital, Arlington Heights, I 0Northwestern Lake Forest Hospital, Lake Forest, IL 0




Exam Rooms 0

Procedure Rooms 0

Ann & Robert H. Lurie Chil

of 292 2/7/2020


Lurie Chiledren's Surgery Center in Northbrook NorthbrookAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Midwest Center for Day Surgery Downers GroveAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,114

8375

1,171881436

2,871

30599

2,0291,565

762

4,985




TOTAL 2,114

0871

21,902

960

2,871

01,559

43,306

1160

4,985




01,861,304 5,703 4,594,635 603,692 7,065,334

0.0%26.3% 0.1% 65.0% 8.5%


0

Charity Care

Expense

0%



Reference Numbers

007

7001076

043

Midwest Center for Day Surgery

3811 Highland Ave

Downers Grove, IL 60515

Administrator

Ronald Ladniak


Registered Agent

Ronald Ladniak

Property Owner

Advocate Healthcare

Legal Owner(s)

Facility Id



Roberta Smith 630-869-6397




Exam Rooms 5

Procedure Rooms



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Advocate Good Samaritan Hospital, Downers Grove 3




Exam Rooms 5

Procedure Rooms

Advocate-SCA Partners

Anshu Chawla

Daniel Luetkehans

George Sosenko

Gilbert Tresley

James Clark

Kenneth Zygmunt

Kevin Kovach

Lesley Dawravoo

Mary Mennella-Nordin

Oscar Alonso

Robert Bastian

Rockford Yapp

Sandeep Jejurikar

Sunil Raichand

of 292 2/7/2020


Midwest Center for Day Surgery Downers GroveAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 643.50 1,569.752093 2213.25 1.06General 0.00 0.000 0.00 0.00Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 0.50 0.751 1.25 1.25Ophthalmology 642.75 1,663.502218 2306.25 1.04Oral/Maxillofacial 21.75 15.7521 37.50 1.79Orthopedic 0.25 0.751 1.00 1.00Otolaryngology 161.00 237.00316 398.00 1.26Pain Management 0.00 0.000 0.00 0.00Plastic Surgery 528.50 171.75229 700.25 3.06Podiatry 59.75 63.7585 123.50 1.45Thoracic 0.00 0.000 0.00 0.00Urology 7.75 15.7521 23.50 1.12

2,065.75 3,738.75TOTAL 4985 5804.50 1.16



60517 215Woodridge

60148 200Lombard

60561 185Darien


60126 140Elmhurst

60559 116Westmont

60439 92Lemont

60532 92Lisle

60101 90Addison

60181 90Villa Park

60137 89Glen Ellyn

60527 88Willowbrook

60565 78Naperville

60523 77Oak Brook

60540 70Naperville

60446 59Romeoville

60564 58Naperville

60544 58Plainfield

60191 55Wood Dale

60490 50Bolingbrook

60521 40Hinsdale

60172 40Roselle



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Midwest Endoscopy Center, LLC NapervilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 3,063

0656

2,212773188

3,829

01,1044,0171,439

332

6,892




TOTAL 3,063

0673

03,153

30

3,829

01,188

05,696

80

6,892




0578,635 0 5,835,025 847,650 7,261,311

0.0%8.0% 0.0% 80.4% 11.7%


0

Charity Care

Expense

0%



Reference Numbers

007

7003127

031

Midwest Endoscopy Center, LLC

1243 Rickert Drive

Naperville, IL 60540

Administrator

Nancy Fielden


Registered Agent

Chris J. Mollet, Esq

Property Owner

DJSB, LLC

Legal Owner(s)

Facility Id



Julie Vaughn 630- 303-5650




Exam Rooms

Procedure Rooms 2



TOTAL 28.00

STAFFING PATTERNS



Type of Ownership




Edward Hospital 5




Exam Rooms

Procedure Rooms 2

Aditya Dholakia, DO

Darren Kastin, MD

Dinesh Jain, MD

Edward Health Venture

Gonzalo Pandolfi, MD

Praveen Mettu, MD

Scott Berger, MD

Shivani Kiriluk, DO

Sushama Gundlapalli, MD

of 292 2/7/2020


Midwest Endoscopy Center, LLC NapervilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

60540 745Naperville

60564 729Naperville

60565 725Naperville

60563 363Naperville


60585 291Plainfield

60544 288Plainfield


60586 246Plainfield

60532 237Lisle

60504 229Aurora

60446 211Romeoville

60543 189Oswego

60517 167Woodridge

60502 145Aurora

60503 94Aurora

60560 92Yorkville

60548 81Sandwich


60403 64Crest Hill

60431 62Joliet

60555 60Warrenville

60435 49Joliet

60538 48Montgomery



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Midwest Eye Center Calumet CityAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 714

122

312407450

1,192

155

529648673

1,906




TOTAL 714

13514

0663

20

1,192

21784

01,094

70

1,906




143,129543,207 0 819,618 968 1,506,922

9.5%36.0% 0.0% 54.4% 0.1%


0

Charity Care

Expense

0%



Reference Numbers

007

7003225

031

Midwest Eye Center

1700 E West Road

Calumet City, IL 60409

Administrator

Afzal Ahmad


Registered Agent

CT Corporation

Property Owner

Health Cap

Legal Owner(s)

Facility Id



Patricia Sanchez 708-891-3330




Exam Rooms 1

Procedure Rooms 1



TOTAL 9.00

STAFFING PATTERNS



Type of Ownership




Advocate Trinity Hospital, Chicago 0




Exam Rooms 1

Procedure Rooms 1

Midwest Eye Center SC

of 292 2/7/2020


Midwest Eye Center Calumet CityAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


427.00 394.00TOTAL 1070 821.00 0.77

Cook 1706

Will 75

Kankakee 56

Lake 52

DuPage 6

Iroquois 4

Kane 2

Joseph 2

Porter 1

Leake 1

Oceana 1



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 836 267 326 0.715931


of 292 2/7/2020


Naperville Fertility Center NapervilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 0

07232300

746

072323

00

746




TOTAL 0

000

637100

9

746

000

637100

9

746




00 0 1,341,928 550,026 1,891,954

0.0%0.0% 0.0% 70.9% 29.1%


10,000

Charity Care

Expense

1%



Reference Numbers

007

7003176

043

Naperville Fertility Center

3 N Washington St


Administrator

Laura Ostrowski


Registered Agent

Jennifer Groszek

Property Owner

Medical Properties

Legal Owner(s)

Facility Id



Laura Ostrowski 630-357-6540




Exam Rooms 0

Procedure Rooms 0



TOTAL 12.00

STAFFING PATTERNS



Type of Ownership




Edward Hospital, Naperville 0




Exam Rooms 0

Procedure Rooms 0

DMG Practice Manage

of 292 2/7/2020


Naperville Fertility Center NapervilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


572.50 763.50TOTAL 746 1336.00 1.79




60532 DuPage 20Lisle

60504 DuPage 20Aurora

60564 Will 20Naperville


60517 DuPage 18Woodridge

60137 DuPage 16Glen Ellyn



60502 DuPage 13Aurora

60431 Will 13Joliet

60545 Kendall 13Plano

60543 Kendall 13Oswego

60189 DuPage 12Wheaton

60538 Kane 12Montgomery

60435 Will 11Joliet


60190 DuPage 10Winfield


60103 DuPage 10Bartlett

60503 Will 10Aurora




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Naperville Surgical Centre NapervilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,930

76493850378158

1,955

1601,0151,663

704343

3,885




TOTAL 1,930

037113

1,035536

0

1,955

0707

332,1441,001

0

3,885




0994,973 4,933 6,221,626 54,414 7,275,946

0.0%13.7% 0.1% 85.5% 0.7%


0

Charity Care

Expense

0%



Reference Numbers

007

7003205

043

Naperville Surgical Centre

1263 Rickert Drive


Administrator

Johnny Estrada


Registered Agent

Jennifer Groszek

Property Owner

Evangelical Services Co

Legal Owner(s)

Facility Id







Exam Rooms 6

Procedure Rooms



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership








Exam Rooms 6

Procedure Rooms

Advocate- SCA Partners

Dupage Medical Group

of 292 2/7/2020


Naperville Surgical Centre NapervilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,337.75 2,913.75TOTAL 3885 5251.50 1.35

60540 302Naperville

60565 276Naperville

60564 243Naperville

60563 188Naperville


60586 117Plainfield

60544 110Plainfield

60585 104Plainfield


60532 99Lisle

60504 99Aurora

60517 94Woodridge

60446 92Romeoville

60543 80Oswego

60137 80Glen Ellyn

60502 68Aurora

60189 64Wheaton

60148 64Lombard

60560 63Yorkville

60503 61Aurora

60187 54Wheaton


60188 52Wheaton

60555 48Warrenville



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


North Shore Surgical Center LincolnwoodAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,312

21,054

442693603

2,794

41,104

7431,1861,069

4,106




TOTAL 1,312

01,173

21,444

1750

2,794

01,984

21,924

1960

4,106




-5,9742,417,085 2,540 4,220,347 166,825 6,800,823

-0.1%35.5% 0.0% 62.1% 2.5%


1,469

Charity Care

Expense

0%



Reference Numbers

007

7003130

031

North Shore Surgical Center

3725 W Tougy Ave

Lincolnwood, IL 60712

Administrator

Dean J. Michal


Registered Agent

CT Corp System

Property Owner

Henry Proessel

Legal Owner(s)

Facility Id



Dean J. Michal 847-324-7770




Exam Rooms 0

Procedure Rooms 0



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




St. Francis 3




Exam Rooms 0

Procedure Rooms 0

Joel Brasch

Jon Rosin

Jon Ruderman

Randy Epstein

Richard Weiss

Robert Rosen

Robert Stein

Tamara Wyse

Tayeb Hussain

of 292 2/7/2020


North Shore Surgical Center LincolnwoodAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,230.50 951.84TOTAL 4106 3182.34 0.78

60062 212Northbrook

60201 198Evanston

60091 186Wilmette

60076 173Skokie

60025 130Glenview

60077 129Skokie


60093 115Winnetka

60202 108Evanston


60645 80Chicago


60015 68Deerfield

60712 61Lincolnwood


60646 54Chicago

60026 49Glenview

60045 49Lake Forest

60090 48Wheeling

60016 45Des Plaines

60714 45Niles

60626 42Chicago

60659 39Chicago

60068 37Park Ridge



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Northwest Community Day Surgery Center Arlington HeightsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,599

1531,2911,357

682549

4,032

3741,8992,2971,163

898

6,631




TOTAL 2,599

1921,193

02,503

1404

4,032

2751,931

04,240

1769

6,631




346,8962,702,228 0 10,555,341 279,435 13,883,900

2.5%19.5% 0.0% 76.0% 2.0%


69,952

Charity Care

Expense

1%



Reference Numbers

007

7001209

031

Northwest Community Day Surgery Center

675 West Kirchoff Road

Arlington Heights, IL 60005

Administrator

Raoul Chazaro, MD, PhD, MBA


Registered Agent

Stephen Scogna, CEO/President

Property Owner

N/A

Legal Owner(s)

Facility Id



Casey Harper, MBA 847-618-7216




Exam Rooms 0

Procedure Rooms 0



TOTAL 45.50

STAFFING PATTERNS



Type of Ownership




Northwest Community Healthcare, Arlington Heights 1




Exam Rooms 0

Procedure Rooms 0

Ajay Balaram, MD

Allan Ho, MD

Brian Donahue, MD

Brian Moss, MD

Daniel R. Conway, MD

David Badawi, MD

Eduard Sladek, MD

Glenn Schwartz, MD

Henry A. Dominicis, MD

Humberto Martinez-Suarez, MD

James Hill, MD

Jason Rotstein, MD

Khalid Husain, MD

Kirk Clark, MD

Lon J. Petchenik, MD

Lorraine S. Novas, MD

Maria Wittkopf, MD

Mark A. Yaffe, MD

Mark N. Levin, MD

Matthew Bernstein, MD

Michael Birman, MD

Michael Ross, MD

Michael Vender, MD

of 292 2/7/2020


Northwest Community Day Surgery Center Arlington HeightsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


7,184.25 2,996.25TOTAL 6631 10180.50 1.54






60008 COOK 304Rolling Meadows

60089 LAKE 289Buffalo Grove








60070 COOK 99Prospect Heights









60013 MCHENRY 52Cary



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Northwest Community Foot and Ankle Center, LLC Des PlainesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 174

598

2438419

449

713632511936

623




TOTAL 174

0720

335420

449

0920

446850

623




025,247 0 1,085,735 55,931 1,166,913

0.0%2.2% 0.0% 93.0% 4.8%


0

Charity Care

Expense

0%



Reference Numbers

007

7003213

031

Northwest Community Foot and Ankle Center, LLC

1455 Golf Road


Administrator

Stephan Scogna


Registered Agent

Northwest Community Healthcar

Property Owner

Designer Direct, Inc.

Legal Owner(s)

Facility Id



Kathleen M Quinlan 847-618-7265




Exam Rooms 1

Procedure Rooms 0



TOTAL 6.70

STAFFING PATTERNS



Type of Ownership




Northwest Community Hospital, Arlington Heights




Exam Rooms 1

Procedure Rooms 0

Gregory Amarantos

Lowell S. Weil, Jr.

Northwest Community Hlth

Wendy Benton-Weil

of 292 2/7/2020


Northwest Community Foot and Ankle Center, LLC Des PlainesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


588.00 286.00TOTAL 623 874.00 1.40

60016 29Des Plaines


60045 20Lake Forest

60047 19Lake Zurich

60025 16Glenview



60010 13Barrington

60015 12Deerfield

60611 12Chicago

60018 12Des Plaines

60068 10Park Ridge

60646 10Chicago


60067 10Palatine

60062 10Northbrook

60093 9Winnetka


60048 9Libertyville

60061 8Vernon Hills

60201 8Evanston

60630 7Chicago

60053 7Morton Grove

60631 7Chicago



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Northwest Endo Center LLC Arlington HeightsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,433

0314

1,438557127

2,436

0619

2,8931,120

237

4,869




TOTAL 2,436

2536

21,888

50

2,433

21,047

113,798

110

4,869




0413,291 0 3,755,337 0 4,168,628

0.0%9.9% 0.0% 90.1% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

007

7003210

031

Northwest Endo Center LLC

1415 S. Arlington Heights Road

Arlington Heights, IL 60005

Administrator

Stephen Scogna


Registered Agent

Northwest Community Healthcar

Property Owner

Northwest Partners, LLC

Legal Owner(s)

Facility Id



Kathy McDonald 847-439-1005




Exam Rooms 0

Procedure Rooms 2



TOTAL 11.00

STAFFING PATTERNS



Type of Ownership




Northwest Community Hospital, Arlington Heights 6




Exam Rooms 0

Procedure Rooms 2

Aaron Benson, MD

Bruce Greenberg, MD

David Kim, MD

David Sales, MD

Eric Yegelwel, MD

Joel Lattin, DO

Kyoko Misawa, MD

Loren White, MD

Mary Kane, MD

Michael Hersh, MD

Mitchell Bernsen, MD

Mitchell Kaplan, MD

Nikos Christopoulos, MD

Patricia Sun, MD

Phithao Nguyen, MD

of 292 2/7/2020


Northwest Endo Center LLC Arlington HeightsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

Cook 3349

Lake 705

DuPage 447

McHenry 178

Kane 128

Will 13

Kendall 5

Walworth 4

Kenosha 3

Washington 2

Maricopa 2

Chatham 2

Boone 2

Berrien 1

Rock 1

Columbia 1

Kauai 1

James City 1

Hays 1

Manatee 1

Wayne 1

Georgetown 1

Sumter 1

New York 1



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Northwest Surgicare Arlington Heights AMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,617

10134457738759

2,098

16267887

1,2531,292

3,715




TOTAL 1,616

01,330

18706440

2,098

02,238

501,342

840

3,714




16,28912,488,784 52,826 10,566,583 225,621 23,350,103

0.1%53.5% 0.2% 45.3% 1.0%


0

Charity Care

Expense

0%



Reference Numbers

007

7000920

031

Northwest Surgicare

1100 West Central Road

Arlington Heights , IL 60005

Administrator

Jennifer Smith Garman


Registered Agent

Property Owner

MedProperties

Legal Owner(s)

Facility Id



Tamara Hargrove 847-259-3080




Exam Rooms 0

Procedure Rooms 2



TOTAL 25.00

STAFFING PATTERNS



Type of Ownership

Partnership (registered with county)



NorthWest Community Hospital 2




Exam Rooms 0

Procedure Rooms 2

Alter, Daniel C.

Ansari, Naveed

Bryan, Kim

Chiu, Michael

Curnyn, Kimberlee

Donahue, Brian

Garcia-Valenzuela, Enrique

Hill, James

Kachar, Sergey M

Ludkowski, Phillip

Moss, Brian

Neal, M. Bryan

Nelson Gregory

Papierski, Paul E,

Piotrowski, Mark J.

Sullivan, Kevin

Tingle, Thomas

Tuttle, Richard

Wood Christopher

Wyhinny, George J.

of 292 2/7/2020


Northwest Surgicare Arlington Heights AMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,517.00 556.20TOTAL 3715 3073.20 0.83


60067 310Palatine



60007 218Elk Grove Village

60074 149Palatine

60193 141Roselle

60008 138Rolling Meadows


60010 110Barrington


60090 75Wheeling

60018 70Des Plaines

60047 66Lake Zurich


60068 57Park Ridge


60107 50Bartlett

60192 44Roselle

60191 42Wood Dale

60173 38Roselle

60194 38Schaumburg

60101 35Addison

60142 29Huntley



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 46 24.75 11 0.7835.751


of 292 2/7/2020


Oak Lawn Endoscopy Center Oak LawnAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,433

0336

1,538771271

2,916

0659

2,8241,395

471

5,349




TOTAL 2,433

0893

02,000

230

2,916

01,532

13,768

480

5,349




0303,818 1,831 3,432,497 323,750 4,061,896

0.0%7.5% 0.0% 84.5% 8.0%


0

Charity Care

Expense

0%



Reference Numbers

007

7003179

031

Oak Lawn Endoscopy Center

9921 Southwest Highway

Oak Lawn, IL 60453

Administrator

Thomas Arndt, MD


Registered Agent

Douglas B. Swill, Esq., Drink

Property Owner

Legal Owner(s)

Facility Id



Helen I Milan, RN 708-425-2552




Exam Rooms 0

Procedure Rooms 2



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Advocate Christ Medical Center Oak Lawn 5




Exam Rooms 0

Procedure Rooms 2

Brian Blumenstein

Charles Berkelhammer

Douglas Lee

Jeffrey Port

Kamran Ayub

Mihir Majmundar

Samir Patel

Thomas Arndt

Vincent Muscarello

Wayne Lue

Zahid Afzal

of 292 2/7/2020


Oak Lawn Endoscopy Center Oak LawnAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00







60463 COOK 185Palos Heights







60803 COOK 116Alsip




60448 WILL 107Mokena

60415 COOK 93Chicago Ridge




60445 COOK 85Midlothian

60451 WILL 84New Lenox



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE


Gastro-Intestinal 5349 3566.3 1782.7 1.0053492

Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Orthotec Surgery Center, Inc ElmhurstAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 61

13248212

104

1517929

5

165




TOTAL 61

0250

7900

104

0370

12800

165




080,283 0 476,564 26,288 583,135

0.0%13.8% 0.0% 81.7% 4.5%


0

Charity Care

Expense

0%



Reference Numbers

007

7003192

043

Orthotec Surgery Center, Inc

340 W Butterfield Road, Suite 1B

Elmhurst, IL 60126

Administrator

Thomas Carr, DPM


Registered Agent

Ellen Carr

Property Owner

TEC Surgical

Legal Owner(s)

Facility Id



Sarah Espino 331-209-9903




Exam Rooms 0

Procedure Rooms 0



TOTAL 6.00

STAFFING PATTERNS



Type of Ownership




Elmhurst Memorial Hospital 1




Exam Rooms 0

Procedure Rooms 0

Charles Mitchell

Daryl O'Connor

Thomas Carr

of 292 2/7/2020


Orthotec Surgery Center, Inc ElmhurstAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


247.25 105.50TOTAL 165 352.75 2.14

60619 13Chicago

60126 11Elmhurst

60148 7Lombard

60637 5Chicago

60649 5Chicago

60191 4Wood Dale

60654 4Chicago

60477 4Tinley Park

60153 3Maywood

60181 3Villa Park

60647 3Chicago

60074 3Palatine

60623 3Chicago

60620 3Chicago


60615 3Chicago

60189 3Wheaton

60638 2Chicago

60160 2Melrose Park

60101 2Addison

60611 2Chicago

60660 2Chicago

60171 2River Grove

60640 2Chicago



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Palos Hills Surgery Center Palos HillsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,145

21275530272150

1,248

42690958466237

2,393




TOTAL 1,145

0339

4902

30

1,248

0543

141,813

194

2,393




0760,687 59,739 5,706,234 43,577 6,570,237

0.0%11.6% 0.9% 86.8% 0.7%


3,417

Charity Care

Expense

0%



Reference Numbers

007

7003186

031

Palos Hills Surgery Center

10330 South Roberts Rd., Suite 300

Palos Hills, IL 60465

Administrator

Ronald P. Ladniak


Registered Agent

Patrick C Keeley

Property Owner

Palos Hills Realty Co.

Legal Owner(s)

Facility Id







Exam Rooms

Procedure Rooms



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Palos Hospital, Palos Heights, IL 1Advocate Christ Hospital, Oak Lawn, IL 0




Exam Rooms

Procedure Rooms

Adam Meisel

Anton J. Fakhouri

Gary Kronen

of 292 2/7/2020


Palos Hills Surgery Center Palos HillsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.000 0.00 0.00General 0.00 0.000 0.00 0.00Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 0.00 0.000 0.00 0.00Ophthalmology 0.00 0.000 0.00 0.00Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 944.00 2,201.562393 3145.56 1.31Otolaryngology 0.00 0.000 0.00 0.00Pain Management 0.00 0.000 0.00 0.00Plastic Surgery 0.00 0.000 0.00 0.00Podiatry 0.00 0.000 0.00 0.00Thoracic 0.00 0.000 0.00 0.00Urology 0.00 0.000 0.00 0.00

944.00 2,201.56TOTAL 2393 3145.56 1.31

60453 220Oak Lawn


60655 100Chicago

60423 95Frankfort

60462 87Orland Park

60448 82Mokena

60467 66Orland Park


60452 61Oak Forest

60451 59New Lenox

60643 55Chicago

60652 52Chicago

60459 50Burbank


60487 49Tinley Park

60803 47Alsip

60638 47Chicago

60465 47Palos Hills

60629 46Chicago

60620 44Chicago

60445 42Midlothian

60617 32Chicago

60628 32Chicago

60482 31Worth



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Palos Surgicenter LLC Palos HeightsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,819

16188727857720

2,508

27366

1,3111,4451,178

4,327




TOTAL 1,819

01,470

01,026

120

2,508

02,380

01,924

230

4,327




01,427,196 0 12,842,531 39,545 14,309,272

0.0%10.0% 0.0% 89.7% 0.3%


1,199

Charity Care

Expense

0%



Reference Numbers

007

7002470

031

Palos Surgicenter LLC

7340 W College Drive

Palos Heights, IL 60463

Administrator

Virginia Forrest


Registered Agent

The St George Corp

Property Owner

Legal Owner(s)

Facility Id



Mary McGill 708-827-2325




Exam Rooms 0

Procedure Rooms 2



TOTAL 19.00

STAFFING PATTERNS



Type of Ownership




Palos Health, Palos Heights 4Christ Advocate, Oak LAwn 1




Exam Rooms 0

Procedure Rooms 2

Anis Mekhail MD

Babu Ponakala MD

Christopher Farley MD

Daniel O'Reilly MD

Duane Brann DPM

Henry Fuentes MD

James Draguesku MD

Kevin Luke MD

Muhamad Amine MD

Nabil Barakat MD

Nicholas Speziale MD

Nirav Shah MD

Palos Health

Paul DeFrino MD

Regent Surgical Health

Scott Becker

Scott Glaser MD

Stephen Krates MD

Steven Wardell MD

William Baylis MD

William Kosmala MD

of 292 2/7/2020


Palos Surgicenter LLC Palos HeightsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


786.79 797.00TOTAL 3352 1583.79 0.47




60463 COOK 239Palos Heights








60803 COOK 113Alsip


60448 WILL 107Mokena

60445 COOK 101Midlothian

60482 COOK 99Worth






60439 COOK 61Lemont


60441 WILL 54Lockport



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Preferred Surgicenter, LLC Orland Park AMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 370

090

1798028

377

021736412145

747




TOTAL 370

010479

181130

377

0158227338

240

747




0450,485 0 3,542,539 295,173 4,288,197

0.0%10.5% 0.0% 82.6% 6.9%


29,000

Charity Care

Expense

1%



Reference Numbers

007

7003193

031

Preferred Surgicenter, LLC

10 Orland Square Drive Ste 10-C

Orland Park , IL 60462

Administrator

Salam Okasha


Registered Agent

Naser Rustom

Property Owner

Orland Park Medical Pla

Legal Owner(s)

Facility Id



Gricel Lopez 708-942-6030




Exam Rooms

Procedure Rooms 1


Director of Nurses 1.00Registered Nurses 3.00Certified AidesOther Health Profs.Other Non-Health Profs 2.00

TOTAL

STAFFING PATTERNS



Type of Ownership




Metro South Blue Island, IL 1




Exam Rooms

Procedure Rooms 1

Naser Rustom, M.D.

of 292 2/7/2020


Preferred Surgicenter, LLC Orland Park AMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


439.00 444.00TOTAL 667 883.00 1.32



60453 Cook 30Oak Lawn


60477 Cook 21Tinley Park



60415 Cook 16Chicago Ridge


60491 Will 14Homer Glen


60465 Cook 13Palos Hills

60459 Cook 13Burbank

60445 Cook 12Midlothian

60402 Cook 12Berwyn



60426 Cook 11Harvey


60455 Cook 10Oak Lawn

60803 Cook 10Alsip


60435 Will 9Joliet

60478 Cook 9Country Club Hills



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Presence Lakeshore Gastroenterology, LLC Des PlainesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 381

0175928557

409

0331197160102

790




TOTAL 381

83142

0166180

409

135262

0353

400

790




42,30092,316 0 450,115 62,922 647,653

6.5%14.3% 0.0% 69.5% 9.7%


0

Charity Care

Expense

0%



Reference Numbers

007

7003215

031

Presence Lakeshore Gastroenterology, LLC

150 N. River Rd. Suite 215


Administrator

Lauren Lavaja


Registered Agent

Lauren Chaplinski

Property Owner

Presence HealthNetwork

Legal Owner(s)

Facility Id



Lauren Lavaja 847-787-1099




Exam Rooms 1

Procedure Rooms 2



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Presence Chicago Hospitals Network 0




Exam Rooms 1

Procedure Rooms 2

LSGLDI Investments

Presence Chicago Hospital

of 292 2/7/2020


Presence Lakeshore Gastroenterology, LLC Des PlainesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00



60068 Cook 37Park Ridge




60018 28Des Plaines

60090 Cook 27Wheeling





60714 Cook 20Niles




60010 Lake 11Barrington


60194 Cook 11Schaumburg

60070 Cook 10Prospect Heights



60053 Cook 10Morton Grove

60047 Lake 9Lake Zurich



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Ravine Way Surgery Center, LLC GlenviewAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,168

6286684347186

1,509

19619

1,166587286

2,677




TOTAL 1,168

143234

1,03750

1,509

2662

971,905

110

2,677




459,8821,140,943 727 8,160,692 46,017 9,808,261

4.7%11.6% 0.0% 83.2% 0.5%


0

Charity Care

Expense

0%



Reference Numbers

007

7003080

031

Ravine Way Surgery Center, LLC

2350 Ravine Way, Suite 500

Glenview, IL 60025

Administrator

Melody Winter-Jabeck


Registered Agent


Property Owner

MB Real Estate

Legal Owner(s)

Facility Id



Melody Winter-Jabeck 847-852-1555




Exam Rooms 0

Procedure Rooms 1



TOTAL 27.73

STAFFING PATTERNS



Type of Ownership




NorthShore University HealthSystem 6




Exam Rooms 0

Procedure Rooms 1

of 292 2/7/2020


Ravine Way Surgery Center, LLC GlenviewAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,963.13 1,115.42TOTAL 2677 3078.55 1.15

60062 221Northbrook


60015 180Deerfield

60025 160Glenview

60091 141Wilmette

60201 118Evanston

60093 106Winnetka


60202 60Evanston

60045 58Lake Forest

60026 54Glenview

60076 51Skokie

60090 47Wheeling

60047 47Lake Zurich


60022 43Glencoe

60031 42Gurnee

60048 39Libertyville

60069 34Lincolnshire


60068 30Park Ridge


60077 28Skokie

60060 27Mundelein



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


River Forest Surgery Center, LLC River ForestAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 563

064

172347331

914

0113265560539

1,477




TOTAL 563

0605

0213924

914

0989

0325156

7

1,477




71,112,227 158 462,734 539,408 2,114,535

0.0%52.6% 0.0% 21.9% 25.5%


0

Charity Care

Expense

0%



Reference Numbers

007

7003211

031

River Forest Surgery Center, LLC

7427 Lake Street

River Forest, IL 60305

Administrator

Kelly D. Spillane


Registered Agent


Property Owner

HSK Partnership

Legal Owner(s)

Facility Id



Kelly D. Spillane 708-488-1300




Exam Rooms 2

Procedure Rooms



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




West Suburban Hospital, Oak Park, IL 0




Exam Rooms 2

Procedure Rooms

Kent A. Kirk

Scott H. Kirk

Walter I. Fried

of 292 2/7/2020


River Forest Surgery Center, LLC River ForestAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


546.00 369.26TOTAL 1477 915.26 0.62

60302 157Oak Park

60305 93River Forest

60085 76Waukegan

60099 72Zion


60031 48Gurnee

60130 46Forest Park

60304 40Oak Park

60096 38Winthrop Harbor

60402 37Berwyn

60087 34Waukegan

60030 29Grayslake

60002 29Antioch

60073 28Round Lake

60154 27Westchester

60160 25Melrose Park

60525 20La Grange

60546 20Riverside

60083 19Wadsworth

60634 17Norridge

60644 17Chicago

60046 16Lake Villa

60064 15North Chicago

60101 15Addison



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Salt Creek Surgery Center WestmontAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,959

30437863290194

1,814

701,0641,768

546325

3,773




TOTAL 1,966

0326

31,468

100

1,807

0558

93,178

280

3,773




0136,075 0 15,639,715 20,000 15,795,790

0.0%0.9% 0.0% 99.0% 0.1%


0

Charity Care

Expense

0%



Reference Numbers

007

7003189

043

Salt Creek Surgery Center

530 N. Cass Avenue

Westmont, IL 60559

Administrator

Lori Hoffer, RN


Registered Agent

Erica Adler, ESQ\Roetzel

Property Owner

Med Properties Group

Legal Owner(s)

Facility Id



Lori L Hoffer, RN 630-869-4260




Exam Rooms 0

Procedure Rooms 0



TOTAL 54.50

STAFFING PATTERNS



Type of Ownership




Adventist Midwest Health d/b/a LaGrange Hospital 6




Exam Rooms 0

Procedure Rooms 0

of 292 2/7/2020


Salt Creek Surgery Center WestmontAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


3,385.00 1,154.30TOTAL 3773 4539.30 1.20


60527 Du Page 135Willowbrook

60561 Du Page 131Darien





60559 Du Page 89Westmont

60521 Du Page 88Hinsdale



60514 Du Page 79Clarendon Hills

60439 Du Page 78Lemont



60431 Will 60Joliet


60517 Du Page 59Woodridge

60404 Will 58Shorewood

60126 Du Page 53Elmhurst



60435 Will 48Joliet

60540 Du Page 45Naperville



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Schaumburg Surgery Center, LLC SchaumburgAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 569

112132512755

629

4285580222107

1,198




TOTAL 580

0141

0474

30

618

0279

0915

40

1,198




02,507,478 0 10,660,434 830,868 13,998,780

0.0%17.9% 0.0% 76.2% 5.9%


0

Charity Care

Expense

0%



Reference Numbers

007

7003217

031

Schaumburg Surgery Center, LLC

929 W Higgins Road FL 2

Schaumburg, IL 60195

Administrator

Annamarie C. York


Registered Agent

MS Registered Agent Services

Property Owner

N/A

Legal Owner(s)

Facility Id



Madeline Augustyn 847-285-4350




Exam Rooms 0

Procedure Rooms 0



TOTAL 15.00

STAFFING PATTERNS



Type of Ownership




St. Alexius Medical Center 1




Exam Rooms 0

Procedure Rooms 0

Brooke Blecher, MD

Ciro Cirrincione, MD

David Tashima, MD

Hasham Alvi, MD

Jason Rotstein, MD

Lynette Mahoney, DPM

Mark Levin, MD

Mark Yaffe, MD

Matthew Bernstein, MD

Narendra Patel, DPM

Paul Nourbash, MD

Raymond O'Hara, DPM

Sean Jereb, MD

Thomas Obermeyer, MD

of 292 2/7/2020


Schaumburg Surgery Center, LLC SchaumburgAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


859.00 509.68TOTAL 1198 1368.68 1.14


60103 Dupage 87Bartlett


60169 Cook 74Hoffman Estates


60194 Cook 54Schaumburg

60172 Dupage 51Roselle




60120 Kane 33Elgin





60118 Kane 24Dundee



60143 Dupage 17Itasca


60101 Dupage 15Addison

60047 Lake 13Lake Zurich

60108 Dupage 13Bloomingdale

60124 Kane 13Elgin



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Southwestern Medical Center, LLC Bedford ParkAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,442

0206703716722

2,347

0322

1,2531,1241,090

3,789




TOTAL 1,442

1931,350

9695100

0

2,347

3322,091

111,232

1221

3,789




144,4802,250,825 0 3,067,183 219,482 5,681,970

2.5%39.6% 0.0% 54.0% 3.9%


700

Charity Care

Expense

0%



Reference Numbers

007

7003159

031

Southwestern Medical Center, LLC

7456 S State Road, Ste 300

Bedford Park, IL 60638

Administrator

Patricia Wamsley, CASC


Registered Agent

Kenneth A Goldstein, Horwood,

Property Owner

Bedford Med, LLC

Legal Owner(s)

Facility Id



Patty Wamsley 773-445-9696




Exam Rooms 1

Procedure Rooms 0



TOTAL 22.00

STAFFING PATTERNS



Type of Ownership




Little Company of Mary 0




Exam Rooms 1

Procedure Rooms 0

George Dangles, MD

John McClellan, MD

John Sonnenberg, MD

Neeraj Jain, MD

Raj Goyal, MD

Richard Foulkes, MD

SW Equity Holding

of 292 2/7/2020


Southwestern Medical Center, LLC Bedford ParkAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,871.00 1,476.50TOTAL 3789 3347.50 0.88

60638 201Chicago

60628 196Chicago

60619 195Chicago

60620 195Chicago

60453 183Oak Lawn

60629 150Chicago

60617 133Chicago

60459 119Burbank

60632 115Chicago

60652 114Chicago

60643 113Chicago

60655 70Chicago

60803 67Alsip

60649 55Chicago

60465 53Palos Hills

60455 51Oak Lawn

60462 49Orland Park

60615 46Chicago

60653 41Chicago

60636 41Chicago

60415 40Chicago Ridge

60621 40Chicago


60477 38Tinley Park



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


The Center for Surgery NapervilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,002

135137429

1,200459

2,360

241307808

2,127879

4,362




TOTAL 2,002

8253674

1,53910920

2,360

1231,016

1612,861

17031

4,362




102,000967,000 49,500 5,770,500 348,000 7,237,000

1.4%13.4% 0.7% 79.7% 4.8%


61,000

Charity Care

Expense

1%



Reference Numbers

007

7001860

043

The Center for Surgery

475 East Diehl Rd


Administrator

Anthony Fato


Registered Agent

Anthony Fato

Property Owner

Legal Owner(s)

Facility Id



Emily Cuddy 630-577-6990




Exam Rooms 0

Procedure Rooms 3



TOTAL 37.00

STAFFING PATTERNS



Type of Ownership








Exam Rooms 0

Procedure Rooms 3

DuPage Doctors LP

Edward Hospital

Northwestern Health Syste

of 292 2/7/2020


The Center for Surgery NapervilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 321.50 67.00516 388.50 0.75General 1,314.75 236.251429 1551.00 1.09Laser Eye Surgery 2.00 2.5021 4.50 0.21Neurology 0.00 0.000 0.00 0.00OB/Gynecology 0.00 0.000 0.00 0.00Ophthalmology 740.50 340.751481 1081.25 0.73Oral/Maxillofacial 1.00 1.001 2.00 2.00Orthopedic 0.00 0.000 0.00 0.00Otolaryngology 367.25 82.75612 450.00 0.74Pain Management 110.25 41.00270 151.25 0.56Plastic Surgery 12.75 2.5014 15.25 1.09Podiatry 2.00 2.002 4.00 2.00Thoracic 0.00 0.000 0.00 0.00Urology 13.00 3.0016 16.00 1.00

2,885.00 778.75TOTAL 4362 3663.75 0.84

60563 235Naperville

60540 218Naperville

60544 212Plainfield

60504 206Aurora

60189 201Wheaton

60586 200Plainfield

60565 187Naperville

60188 171Wheaton

60446 164Romeoville


60564 111Naperville

60517 99Woodridge

60502 97Aurora

60532 95Lisle

60137 87Glen Ellyn

60126 84Elmhurst

60505 75Aurora

60490 67Bolingbrook

60431 65Joliet

60548 65Sandwich

60560 64Yorkville

60506 63Aurora

60187 58Wheaton

60450 56Morris



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


The Glen Endoscopy Center GlenviewAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,966

0318

1,314668263

2,563

0557

2,2731,220

479

4,529




TOTAL 1,966

1765

01,780

170

2,563

41,343

03,153

290

4,529




2,176290,797 180 3,822,836 445,837 4,561,826

0.0%6.4% 0.0% 83.8% 9.8%


0

Charity Care

Expense

0%



Reference Numbers

007

7003174

031

The Glen Endoscopy Center

2551 Compass Road Suite 115

Glenview, IL 60026

Administrator

Beth Mara


Registered Agent


Property Owner

AugFive LP

Legal Owner(s)

Facility Id



Beth Mara 847-656-2400




Exam Rooms 0

Procedure Rooms 3



TOTAL 11.00

STAFFING PATTERNS



Type of Ownership




Skokie Hospital, Skokie, IL 2




Exam Rooms 0

Procedure Rooms 3

Amsurg

Dr. Alan Shapiro

Dr. Baseer Qazi

Dr. Douglas Adler

Dr. Jeffrey Jacobs

Dr. John Vainder

Dr. Jonathan Williams

Dr. Karen Sable

Dr. Kenneth Chi

Dr. Nina Merel

Dr. Ronald Bloom

Dr. Yolandra Johnson

of 292 2/7/2020


The Glen Endoscopy Center GlenviewAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

60062 440Northbrook

60025 286Glenview

60091 175Wilmette


60068 172Park Ridge

60093 166Winnetka

60015 165Deerfield



60026 154Glenview



60076 122Skokie

60714 115Niles

60201 99Evanston

60631 91Chicago

60090 90Wheeling

60022 82Glencoe

60077 82Skokie


60646 78Chicago

60018 66Des Plaines

60630 51Chicago




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


The Oak Brook Surgical Centre, Inc. Oak BrookAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 720

6779451911769

1,566

1321,082

81117586

2,286




TOTAL 720

8187

0980391

0

1,566

9264

01,281

7320

2,286




0284,443 0 7,375,731 1,090,164 8,750,338

0.0%3.3% 0.0% 84.3% 12.5%


0

Charity Care

Expense

0%



Reference Numbers

007

7001548

043

The Oak Brook Surgical Centre, Inc.

2425 W. 22nd St., Ste. 101

Oak Brook, IL 60523

Administrator

Ali Nili


Registered Agent

Paul Gilman

Property Owner

Legal Owner(s)

Facility Id







Exam Rooms 1

Procedure Rooms 0



TOTAL 21.00

STAFFING PATTERNS



Type of Ownership




Good Samaritan Hospital, Downers Grove 1




Exam Rooms 1

Procedure Rooms 0

Kianoosh Jafari, MD

of 292 2/7/2020


The Oak Brook Surgical Centre, Inc. Oak BrookAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,295.75 456.00TOTAL 2074 1751.75 0.84

99999 Unknown 117


60181 DUPAGE 32Villa Park













60402 COOK 20Berwyn

60517 DUPAGE 19Woodridge

60561 DUPAGE 19Darien

60521 DUPAGE 19Hinsdale





60525 COOK 17La Grange



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



IVIG Infusion Thera 212 863.75 52.5 4.32916.25

Laser Eye 0 0 0 0.0000

of 292 2/7/2020


Tinley Woods Surgery Center Tinley ParkAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,994

222375792993897

3,279

464554

1,3001,5391,416

5,273




TOTAL 1,994

0737

12,409

1320

3,279

01,179

13,942

1510

5,273




01,398,431 410 6,102,172 329,600 7,830,613

0.0%17.9% 0.0% 77.9% 4.2%


0

Charity Care

Expense

0%



Reference Numbers

007

7002652

031

Tinley Woods Surgery Center

18200 S. LaGrange Road

Tinley Park, IL 60487

Administrator

Ronald P. Ladniak


Registered Agent

Ronald Ladniak

Property Owner

Evangelical Services Co

Legal Owner(s)

Facility Id







Exam Rooms 6

Procedure Rooms 1



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Advocate South Suburban, Hazel Crest, IL 3Advocate Christ Hospital, Oak Lawn, IL 0




Exam Rooms 6

Procedure Rooms 1

Anton J. Fakhouri

Benjamin H. Ticho

Christopher J. Neal

Curtis G. Walsh

Daniel L. Luetkehans

David L. Zumerchik

Dennis R. LaMonte

Edward C. Ryan

Emil J. Zager

Eric W. Johnston

Evan T. Manolis

Hareth M. Raddawi

Jonathan S. Buka

Kabita S. Shifrin

Kenneth Finkelstein

Krystyna Gal

Lawrence D.Boysen

Leah Urbanosky

Luis E. Ugarte

Michael A. DeVito

Nicholas R. Cudney

Nirav N. Thakkar

Ramasamy Kalimuthu

of 292 2/7/2020


Tinley Woods Surgery Center Tinley ParkAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,903.75 3,465.75TOTAL 4621 5369.50 1.16





60423 179Frankfort

60452 165Oak Forest

60443 155Matteson

60643 142Chicago


60448 138Mokena

60453 136Oak Lawn

60628 121Chicago

60620 120Chicago

60466 115Park Forest

60451 98New Lenox

60655 95Chicago

60430 93Homewood

60478 85Country Club Hills

60617 84Chicago

60491 79Homer Glen

60417 75Crete

60409 71Calumet City

60803 70Alsip

60652 69Chicago



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


United Shockwave Services, LTD. LaGrangeAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 412

056

1196926

270

012731615782

682




TOTAL 412

30821

15700

270

55208

1418

00

682




92,081443,331 7,756 1,758,777 0 2,301,946

4.0%19.3% 0.3% 76.4% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

007

7003190

031

United Shockwave Services, LTD.

120 N. LaGrange Rd.

LaGrange, IL 60525

Administrator

Jamie M. Ejka


Registered Agent


Property Owner

UUC RealEST HLD,LLC

Legal Owner(s)

Facility Id



Jamie M. Ejka 847-544-5959




Exam Rooms 1

Procedure Rooms 0



TOTAL 6.50

STAFFING PATTERNS



Type of Ownership




AMITA Health Adventist Medical Center, LaGrange, I 1




Exam Rooms 1

Procedure Rooms 0

Charles Durkee

Jeffrey Norris

Joel Cornfield

of 292 2/7/2020


United Shockwave Services, LTD. LaGrangeAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


682.00 341.00TOTAL 682 1023.00 1.50

60402 32Berwyn

60126 25Elmhurst

60525 25La Grange

60638 24Chicago

60804 23Cicero

60629 19Chicago

60302 15Oak Park

60639 13Chicago


60534 12Lyons

60561 12Darien

60647 12Chicago

60101 11Addison

60527 11Willowbrook

60632 11Chicago

60513 10Brookfield

60439 10Lemont

60154 10Westchester

60187 9Wheaton

60148 9Lombard

60403 8Crest Hill

60453 7Oak Lawn

60304 7Oak Park

60564 7Naperville



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Uropartners Surgery Center Des PlainesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,149

059

1568948

352

0194614475218

1,501




TOTAL 1,149

0127

0219

60

352

5583

0891

220

1,501




3,355626,555 0 1,645,474 151,065 2,426,450

0.1%25.8% 0.0% 67.8% 6.2%


0

Charity Care

Expense

0%



Reference Numbers

007

7003212

031

Uropartners Surgery Center

2750 S River Rd


Administrator

Cathrine McCue


Registered Agent

Neal Goldstein

Property Owner

Urpartners Real

Legal Owner(s)

Facility Id



Christopher Setzler 708-273-3031




Exam Rooms 0

Procedure Rooms 0



TOTAL 20.00

STAFFING PATTERNS



Type of Ownership




Resurrection Medical Center, Chicago 0




Exam Rooms 0

Procedure Rooms 0

Richard Harris, MD

of 292 2/7/2020


Uropartners Surgery Center Des PlainesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.000 0.00 0.00General 0.00 0.000 0.00 0.00Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 0.00 0.000 0.00 0.00Ophthalmology 0.00 0.000 0.00 0.00Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 0.00 0.000 0.00 0.00Otolaryngology 0.00 0.000 0.00 0.00Pain Management 85.00 40.7587 125.75 1.45Plastic Surgery 0.00 0.000 0.00 0.00Podiatry 0.00 0.000 0.00 0.00Thoracic 1,020.00 553.001414 1573.00 1.11Urology 0.00 0.000 0.00 0.00

1,105.00 593.75TOTAL 1501 1698.75 1.13

60068 29Park Ridge

60634 28Norridge

60631 26Chicago

60618 23Chicago


60625 22Chicago

60030 21Grayslake

60016 21Des Plaines

60614 21Chicago

60103 20Bartlett


60646 19Chicago

60134 18Geneva


60640 18Chicago



60193 17Roselle

60630 16Chicago

60090 16Wheeling


60189 16Wheaton

60062 15Northbrook

60031 15Gurnee



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Advocate Surgery Center- Libertyville LibertyvilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 938

12136334140102

724

44349726326217

1,662




TOTAL 938

1823520

44920

724

40494

981,022

80

1,662




83,0051,113,757 747,885 8,145,246 34,523 10,124,415

0.8%11.0% 7.4% 80.5% 0.3%


2,961

Charity Care

Expense

0%



Reference Numbers

008

7003208

097

Advocate Surgery Center- Libertyville

825 S. Milwaukee Ave

Libertyville, IL 60048

Administrator

Mark Lieberthal


Registered Agent


Property Owner

Advocate Condell MC

Legal Owner(s)

Facility Id



Brittany Nessel 224-504-2217




Exam Rooms 1

Procedure Rooms 0



TOTAL 15.60

STAFFING PATTERNS



Type of Ownership




Advocate Condell Medical Center 1




Exam Rooms 1

Procedure Rooms 0

Advocate-SCA Partners

CASC II, LLC

Neuro, LLC

Raza Khan, MD

Zachary Domont, MD

of 292 2/7/2020


Advocate Surgery Center- Libertyville LibertyvilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,547.48 892.04TOTAL 1662 2439.52 1.47

60073 143Round Lake

60030 142Grayslake

60060 117Mundelein

60048 Libertyville 109Libertyville

60002 99Antioch

60031 93Gurnee

60085 91Waukegan

60046 78Lake Villa


60087 51Waukegan

60099 41Zion

60047 38Lake Zurich

60089 Buffalo Grove 34Buffalo Grove

60045 29Lake Forest


60041 24Ingelside

60020 24Fox Lake

60051 21McHenry

60083 20Wadsworth


60084 17Wauconda

60015 Deerfield 15Deerfield

60090 14Wheeling

60010 14Barrington



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Algonquin Road Surgery Center, LLC Lake in the HillsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,535

52392881391250

1,966

132747

1,578673371

3,501




TOTAL 1,535

2536

71,402

190

1,966

3840

92,627

220

3,501




24,1081,395,850 47,722 6,966,075 125,000 8,558,755

0.3%16.3% 0.6% 81.4% 1.5%


0

Charity Care

Expense

0%



Reference Numbers

008

7002579

111

Algonquin Road Surgery Center, LLC

2550 West Algonquin Road

Lake in the Hills, IL 60156

Administrator

Lori Callahan


Registered Agent

Lori Callahan

Property Owner

ARSC Real Estates Hold

Legal Owner(s)

Facility Id



Lori Callahan 847.960.1045




Exam Rooms 4

Procedure Rooms 1



TOTAL

STAFFING PATTERNS



Type of Ownership




Advocate Sherman Hospital 3Centegra Huntley - Northwestern 1




Exam Rooms 4

Procedure Rooms 1

ARSC Physician Holdings,

Northern Illinois Medical C

Sherman Hospital Advocat

of 292 2/7/2020


Algonquin Road Surgery Center, LLC Lake in the HillsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,349.75 720.00TOTAL 2948 3069.75 1.04

McHenry 2073

Kane 850

Lake 184

Cook 165

De Kalb 27

Boone 18

Du Page 17

Winnebago 12

Walworth 8

Racine 3

La Salle 3

Ogle 2

Kenosha 2

Will 2

Rock 1

Davidson 1

Hamilton 1

Shelby 1

Tuscaloosa 1

Rock Island 1

Stephenson 1

Hillsborough 1

Sumner 1

Sheridan 1



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE


Gastro-Intestinal 553 267.5 139.5 0.744071

Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Barrington Pain & Spine Institute BarringtonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,370

1259890595473

2,218

1481

1,443942721

3,588




TOTAL 1,370

121,339

0867

00

2,218

252,009

01,554

00

3,588




6,302801,056 71 2,986,098 0 3,793,527

0.2%21.1% 0.0% 78.7% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

008

7003167

097

Barrington Pain & Spine Institute

600 Hart Road Suite 300

Barrington, IL 60010

Administrator

Donna Havemann


Registered Agent

John V. Prunskis MD

Property Owner

Varde Scratch & Dent

Legal Owner(s)

Facility Id



Donna Havemann 224-535-7011




Exam Rooms 0

Procedure Rooms 1



TOTAL 14.00

STAFFING PATTERNS



Type of Ownership




Good Shepherd 5




Exam Rooms 0

Procedure Rooms 1

Asghar Rizvi, MD

Chadi Yaacoub, MD

John V. Prunskis, MD

Terri Dallas-Prunskis, MD

of 292 2/7/2020


Barrington Pain & Spine Institute BarringtonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


295.75 91.50TOTAL 688 387.25 0.56

60014 246Crystal Lake

60050 245Mc Henry

60010 222Barrington

60142 214Huntley

60098 187Woodstock

60047 139Lake Zurich

60156 137Lake in the Hills

60051 133McHenry

60013 129Cary

60102 114Algonquin

60123 84Elgin


60140 70Hampshire

60097 68Wonder Lake

60118 67Dundee

60073 65Round Lake

60193 63Roselle

60033 52Harvard

60041 50Ingelside

60030 47Grayslake

60042 47Island Lake

60120 47Elgin

60152 45Marengo

60071 43Richmond



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000

Pain Management 2902 1050.25 386.75 0.5014371

of 292 2/7/2020


Castle Surgicenter AuroraAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 785

7136335221146

845

17313651380269

1,630




TOTAL 785

3324

0518

00

845

5554

01,070

10

1,630




0252,901 0 2,973,175 137,159 3,363,235

0.0%7.5% 0.0% 88.4% 4.1%


0

Charity Care

Expense

0%



Reference Numbers

008

7003207

089

Castle Surgicenter

2111 Ogden Ave.

Aurora, IL 60504

Administrator

Barry Finn


Registered Agent

Barry Finn

Property Owner

Carter Validus

Legal Owner(s)

Facility Id



Patricia Darimont RN ONC 630-978-3800




Exam Rooms

Procedure Rooms



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Copley Memorial Hospital 0Presence Mercy Medical Center 0




Exam Rooms

Procedure Rooms

of 292 2/7/2020


Castle Surgicenter AuroraAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


751.50 675.50TOTAL 1630 1427.00 0.88

60543 KENDALL 227Oswego

60560 KENDALL 170Yorkville


60538 KENDALL 146Montgomery



60545 KENDALL 60Plano

60548 DEKALB 59Sandwich

60554 KANE 58Sugar Grove

60503 WILL 56Aurora




60552 DEKALB 26Somonauk



60541 KENDALL 17Newark




60450 GRUNDY 13Morris

60511 KANE 12Big Rock

60551 LASALLE 10Sheridan




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Dreyer Ambulatory Surgery Center AuroraAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 5,771

159924

2,6881,8391,291

6,901

3611,6435,0793,3352,254

12,672




TOTAL 5,771

01,759

05,125

170

6,901

03,073

09,567

320

12,672




02,052,035 0 12,683,850 44,311 14,780,196

0.0%13.9% 0.0% 85.8% 0.3%


0

Charity Care

Expense

0%



Reference Numbers

008

7001779

089

Dreyer Ambulatory Surgery Center

1221 N. Highland Ave

Aurora, IL 60506

Administrator

Tammy Robinson


Registered Agent

Property Owner

Legal Owner(s)

Facility Id



Judy Gregorowicz 630-264-8405




Exam Rooms 0

Procedure Rooms 6



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership

Partnership (registered with county)



Amita Health Mercy Medical Center, Aurora 11Rush Copley Medical Center, Aurora 0




Exam Rooms 0

Procedure Rooms 6

Advocate Medical Group W

Amita Health Mercy Medical

of 292 2/7/2020


Dreyer Ambulatory Surgery Center AuroraAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,470.50 1,125.50TOTAL 3502 2596.00 0.74

60506 2249Aurora

60543 1427Oswego

60505 1169Aurora

60538 945Montgomery



60510 594Batavia

60554 536Sugar Grove

60504 465Aurora

60545 KENDALL 342Plano

60548 298Sandwich

60134 KANE 288Geneva

60502 215Aurora

60174 171St. Charles

60586 161Plainfield

60503 133Aurora

60520 DEKALB 128Hinckley


60119 KANE 117Elburn

60552 117Somonauk

60544 102Plainfield

60564 101Naperville

60115 DEKALB 93De Kalb

60511 93Big Rock



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 324 6.5 0 0.026.51

Pain Management 2182 202 269.25 0.22471.251

of 292 2/7/2020


Elgin Gastroenterology Endoscopy Center, LLC ElginAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,379

0398

1,455718230

2,801

0674

2,8181,280

408

5,180




TOTAL 2,379

0861

01,934

60

2,801

01,535

03,630

150

5,180




0828,776 0 4,273,439 52,021 5,154,236

0.0%16.1% 0.0% 82.9% 1.0%


0

Charity Care

Expense

0%



Reference Numbers

008

7003015

089

Elgin Gastroenterology Endoscopy Center, LLC

745 Fletcher Dr #201

Elgin, IL 60123

Administrator

same as above


Registered Agent

Lawrence Kosinski

Property Owner

Freidman Real Estate

Legal Owner(s)

Facility Id



susan theobald 847 8885711




Exam Rooms

Procedure Rooms 2



TOTAL 13.90

STAFFING PATTERNS



Type of Ownership




Advocate Sheman Hospital 9Presence St Joseph Hospital 1




Exam Rooms

Procedure Rooms 2

Gregory Gambla

James Stinneford

Jennifer Dorfmeister

Joseph Losurdo

Lawrence Kosinski

Physicians Endoscopy

Raj Pillai

Sonia Godambe

Sunil Joseph

Wei Sun

William Levis

of 292 2/7/2020


Elgin Gastroenterology Endoscopy Center, LLC ElginAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

60123 846Elgin

60124 501Elgin

60142 499Huntley

60120 433Elgin

60140 345Hampshire

60102 313Algonquin

60115 268De Kalb

60156 260Lake in the Hills

60177 243South Elgin


60136 139Gilberts


60103 107Bartlett

60152 76Marengo

60010 61Barrington

60098 49Woodstock

60107 48Bartlett

60135 46Genoa

60178 45Sycamore

60174 44St. Charles

60013 43Cary

60134 39Geneva

60119 35Elburn




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Fox Valley Orthopedics GenevaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,237

26258639277143

1,343

60596

1,193496235

2,580




TOTAL 1,237

135239

939120

1,343

1605145

1,795340

2,580




0889,299 1,230,974 713,400 142,392 2,976,066

0.0%29.9% 41.4% 24.0% 4.8%


0

Charity Care

Expense

0%



Reference Numbers

008

7002165

089

Fox Valley Orthopedics

2525 Kaneville Rd.

Geneva, IL 60134

Administrator

Barry Mathews


Registered Agent

Craig M. Torosian

Property Owner

Hammes Company

Legal Owner(s)

Facility Id



Bruno Lopez 630-938-4007




Exam Rooms 1

Procedure Rooms 1



TOTAL 43.00

STAFFING PATTERNS



Type of Ownership




Delnor Community Hospital, Geneva 3




Exam Rooms 1

Procedure Rooms 1

Craig M. Torosian, MD

David R Morawski, MD

Eric K Bartel, MD

James P Sostak, MD

Jasper A Petrucci, MD

Kevan E Ketterling, MD

Thomas A Atkins, MD

Timothy S Petsche, MD

Vishal M Mehta, MD

of 292 2/7/2020


Fox Valley Orthopedics GenevaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,632.00 774.00TOTAL 2580 3406.00 1.32

60134 319Geneva


60510 234Batavia


60123 147Elgin

60124 140Elgin


60119 111Elburn

60542 93North Aurora

60140 72Hampshire

60554 58Sugar Grove

60506 57Aurora

60120 53Elgin

60178 49Sycamore

60151 41Maple Park

60115 34De Kalb

60118 34Dundee

60102 34Algonquin

60142 33Huntley


60543 27Oswego


60560 21Yorkville

60103 20Bartlett



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Hawthorn Place Outpatient Surgery Center L.P. Vernon HillsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,782

89531

1,217509304

2,650

2041,3412,504

876507

5,432




TOTAL 2,782

0778111

1,75470

2,650

21,290

4323,676

320

5,432




-12,7441,310,409 3,542,329 14,374,159 128,278 19,342,431

-0.1%6.8% 18.3% 74.3% 0.7%


0

Charity Care

Expense

0%



Reference Numbers

008

7003188

097

Hawthorn Place Outpatient Surgery Center L.P.

240 Center Drive

Vernon Hills, IL 60061

Administrator

Marion (Amy) Panagopoulos


Registered Agent

CT Corporation

Property Owner

HSA

Legal Owner(s)

Facility Id



Marion (Amy) Panagopoulos 847-367-8100




Exam Rooms 0

Procedure Rooms 0



TOTAL 37.00

STAFFING PATTERNS



Type of Ownership




Advocate Condell Medical Center 5Northwestern Lake Forest Hospital 0




Exam Rooms 0

Procedure Rooms 0

Anand Vora

Bruce Summerville

Christ Pavlatos

Craig Williams

David Hamming

Demetrios Louis

Edward Logue

Katherine Hamming

Mark Hamming

Nejd Alsikafi

Paul Marsiglia

Peter Hoepfner

Peter Thadani

Roger Chams

Serafin Deleon

Standford Tack

Thomas Baier

Tomas Nemickas

of 292 2/7/2020


Hawthorn Place Outpatient Surgery Center L.P. Vernon HillsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


3,636.25 3,316.85TOTAL 5432 6953.10 1.28

60031 441Gurnee

60046 439Lake Villa

60030 433Grayslake

60073 337Round Lake

60085 336Waukegan


60002 303Antioch

60045 244Lake Forest

60060 225Mundelein

60099 221Zion

60087 197Waukegan


60083 136Wadsworth

60044 101Lake Bluff

60047 87Lake Zurich

60041 69Ingelside



60051 64McHenry

60020 61Fox Lake

60015 54Deerfield

60081 50Spring Grove

60064 50North Chicago




PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Lindenhurst Surgery Center LLC LindenhurstAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 857

555

291466383

1,200

17106520768646

2,057




TOTAL 857

62765

5342260

1,200

1141,226

9656

520

2,057




1,783,352316,974 0 1,399,066 155,916 3,655,308

48.8%8.7% 0.0% 38.3% 4.3%


0

Charity Care

Expense

0%



Reference Numbers

008

7003168

097

Lindenhurst Surgery Center LLC

1050 Red Oak Lane

Lindenhurst, IL 60046

Administrator

Norman Stephens


Registered Agent


Property Owner

Waukegan IL Hosp Co

Legal Owner(s)

Facility Id



Elizabeth George 847-360-3000




Exam Rooms

Procedure Rooms 2



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Vista Medical Center East, Waukegan, IL




Exam Rooms

Procedure Rooms 2

Alsikafi MD, Nejd

Alzate MD, Juan

Atzeff MD, Kristopher

Cohen MD, Justin

Collins MD, Roger

DeLeon MD, Serafin

Erickson MD, Robert

Gandhi MD, Sanjay

Green MD, Daniel

Greenberg MD, Rachael

Hicks DPM, Jeff

Jackson MD, Mitchell

Johnson MD, Benjamin

Khan MD, Raza

Kim MD, Ron

Liesen MD, Daniel

Parikh DO, Amit

Patel MD, Sutchin

Reinglass MD, Steven

Scheer MD, Michael

Siegel MD, Aaron

Strohmayer MD, Paul

Waukegan Ill Hosp Co

of 292 2/7/2020


Lindenhurst Surgery Center LLC LindenhurstAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


610.00 514.50TOTAL 2057 1124.50 0.55

60046 LAKE 264Lake Villa

60002 LAKE 260Antioch

60073 LAKE 198Round Lake

60030 LAKE 171Grayslake


60031 LAKE 116Gurnee


60099 LAKE 82Zion

60041 LAKE 62Ingelside

60020 LAKE 58Fox Lake

60048 LAKE 58Libertyville

60060 LAKE 58Mundelein


60083 LAKE 39Wadsworth

60081 MCHENRY 28Spring Grove

60096 LAKE 27Winthrop Harbor


60061 LAKE 19Vernon Hills

53179 KENOSHA 17

60064 LAKE 17North Chicago


53104 KENOSHA 15


60045 LAKE 12Lake Forest



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


North Shore Endoscopy Center Lake BluffAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,617

0231

1,038496160

1,925

0409

1,918914301

3,542




TOTAL 1,925

048815

1,091230

1,617

01,079

232,400

400

3,542




0530,779 18,328 2,463,121 24,962 3,037,189

0.0%17.5% 0.6% 81.1% 0.8%


0

Charity Care

Expense

0%



Reference Numbers

008

7002926

097

North Shore Endoscopy Center

101 S. Waukegan Rd. Suite 980

Lake Bluff, IL 60044-3013

Administrator

Christopher Macalaguin


Registered Agent

Corporation Service Company

Property Owner

J. Emil Anderson & Son

Legal Owner(s)

Facility Id



Cristina Baker 615-240-3788




Exam Rooms 8

Procedure Rooms 2



TOTAL 11.00

STAFFING PATTERNS



Type of Ownership




Advocate Condell Medical Center Libertyville




Exam Rooms 8

Procedure Rooms 2

AmSurg Holdings, Inc.

North Shore Endoscopy Ve

of 292 2/7/2020


North Shore Endoscopy Center Lake BluffAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00





60099 LAKE 240Zion





60035 LAKE 109Highland Park


60015 LAKE 96Deerfield




60096 LAKE 64Winthrop Harbor



60062 COOK 50Northbrook


60044 LAKE 37Lake Bluff






PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Northwestern Grayslake Ambulatory Surgery Cent GrayslakeAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 633

6227230115078

863

162438529242125

1,496




TOTAL 633

12320516

461535

863

217315

72822

6010

1,496




360,069766,856 515,482 4,633,139 63,382 6,338,928

5.7%12.1% 8.1% 73.1% 1.0%


36,985

Charity Care

Expense

1%



Reference Numbers

008

7003156

097

Northwestern Grayslake Ambulatory Surgery Center

1475 E Belvidere Road, Suite 211

Grayslake, IL 60030

Administrator

Denise Majeski


Registered Agent

Property Owner

Legal Owner(s)

Facility Id







Exam Rooms 0

Procedure Rooms 0



TOTAL 15.95

STAFFING PATTERNS



Type of Ownership




Northwestern Lake Forest Hospital 0Ann and Roberts H. Lurie Childrens 1Advocate Condell Medical Center 0




Exam Rooms 0

Procedure Rooms 0

of 292 2/7/2020


Northwestern Grayslake Ambulatory Surgery Cent GrayslakeAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,424.00 756.50TOTAL 1496 2180.50 1.46









60099 LAKE 40Zion







60062 COOK 24Northbrook











PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Northwestern Grayslake Endoscopy Center GrayslakeAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,036

018678230388

1,359

0307

1,354562172

2,395




TOTAL 1,036

6736711

90095

1,359

107671

191,578

137

2,395




87,541589,067 42,650 4,872,118 7,537 5,598,913

1.6%10.5% 0.8% 87.0% 0.1%


20,792

Charity Care

Expense

0%



Reference Numbers

008

7003180

097

Northwestern Grayslake Endoscopy Center

1475 E Belvidere Road, Suite 303

Grayslake, IL 60030

Administrator

Denise Majeski


Registered Agent

Property Owner

Legal Owner(s)

Facility Id







Exam Rooms 0

Procedure Rooms 2



TOTAL 8.21

STAFFING PATTERNS



Type of Ownership




Northwestern Medicine Lake Forest Hospital 0Northwestern Medicine Grayslake Ambulatory ED 4Advocate Condell Medical Center 0




Exam Rooms 0

Procedure Rooms 2

of 292 2/7/2020


Northwestern Grayslake Endoscopy Center GrayslakeAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00















60099 LAKE 36Zion







53158 KENOSHA 19


60069 LAKE 18Lincolnshire



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Ritacca Laser Center, Ltd Vernon HillsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 345

033213713213

614

049427515733

959




TOTAL 259

0150

178507

0

700

0280

363568

0

959




0101,211 0 645,509 297,219 1,043,939

0.0%9.7% 0.0% 61.8% 28.5%


0

Charity Care

Expense

0%



Reference Numbers

008

7003144

097

Ritacca Laser Center, Ltd

230 Center Drive

Vernon Hills, IL 60061

Administrator

Grisel Lopez


Registered Agent

Robert Masini

Property Owner

Daniel Ritacca

Legal Owner(s)

Facility Id



Kendra Gurdak 847-367-8764




Exam Rooms 0

Procedure Rooms 0



TOTAL 10.00

STAFFING PATTERNS



Type of Ownership

Sole Proprietorship



Advocate Condell Medical Center-Libertyville, IL 0




Exam Rooms 0

Procedure Rooms 0

Daniel Ritacca

Jay Joshi

Leonard Lu

of 292 2/7/2020


Ritacca Laser Center, Ltd Vernon HillsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,157.65 432.20TOTAL 959 1589.85 1.66

60061 Lake 145Vernon Hills

60099 Lake 113Zion

60002 Lake 109Antioch


60030 Lake 41Grayslake

60031 Lake 35Gurnee

60073 Lake 34Round Lake

60015 Lake 34Deerfield

60045 Lake 27Lake Forest

60714 Cook 23Niles


60048 Lake 22Libertyville




60463 Cook 17Palos Heights

60402 Cook 15Berwyn

60060 Lake 14Mundelein


60070 Cook 14Prospect Heights

60035 Cook 13Highland Park






PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Valley Ambulatory Surgery Center St. CharlesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,859

144495

1,430823492

3,384

317786

2,7321,558

850

6,243




TOTAL 2,859

21,259

102,070

430

3,384

42,209

423,918

682

6,243




2,3031,912,892 211,115 8,130,616 411,679 10,668,604

0.0%17.9% 2.0% 76.2% 3.9%


2,429

Charity Care

Expense

0%



Reference Numbers

008

7001217

089

Valley Ambulatory Surgery Center

2210 Dean Street

St. Charles, IL 60175

Administrator

Daniel C. Hauer, CASC


Registered Agent

CT Corporation

Property Owner

Valley Medical BldgCorp

Legal Owner(s)

Facility Id



Daniel C. Hauer, CASC 630-584-9800




Exam Rooms 1

Procedure Rooms 1



TOTAL 39.58

STAFFING PATTERNS



Type of Ownership




Northwestern Delnor Hospital Geneva 3AMITA Health St. Josephs Hospital, Elgin 0Advocate Sherman Hospital Elgin 0Rush Copley Medical Center Aurora 0AMITA Health Mercy Medical Center Aurora 0




Exam Rooms 1

Procedure Rooms 1

Andrew Kramer, M.D.

Anjali Hawkins, MD PhD

Anthony Giamberdino, M.D.

Anthony Pollastrini, D.P.M.

ARC Financial Services, Inc.

Brian Heffelfinger, M.D.

Christopher Hampson, M.D.

Christopher Michael, M.D.

D. James Lee, M.D.

Darran Moxon, M.D.

David Aguiar, M.D.

David Hemmer, M.D.

Eric Quartetti, M.D.

Ernest Isadore, D.P.M.

Eveline Tan, D.P.M.

Glen Lochmueller, M.D.

Harry Bernstein, M.D.

Hythem Shadid, M.D.

James Fister, M.D.

Janeta Dimante, M.D.

Jeffrey Grosskopf, M.D.

John White, M.D.

Katherine Brito, M.D.

of 292 2/7/2020


Valley Ambulatory Surgery Center St. CharlesAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 3.25 3.004 6.25 1.56Gastroenterology 1,011.75 1,237.002749 2248.75 0.82General 196.25 156.75209 353.00 1.69Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 1.00 1.001 2.00 2.00OB/Gynecology 191.75 173.25231 365.00 1.58Ophthalmology 357.25 609.001218 966.25 0.79Oral/Maxillofacial 195.00 63.50127 258.50 2.04Orthopedic 507.00 673.50449 1180.50 2.63Otolaryngology 575.50 225.50451 801.00 1.78Pain Management 63.00 231.50463 294.50 0.64Plastic Surgery 159.25 36.0036 195.25 5.42Podiatry 299.00 280.50187 579.50 3.10Thoracic 0.00 0.000 0.00 0.00Urology 75.75 73.25118 149.00 1.26

3,635.75 3,763.75TOTAL 6243 7399.50 1.19

60134 861Geneva



60510 602Batavia

60119 257Elburn


60124 249Elgin


60123 171Elgin

60178 132Sycamore

60554 125Sugar Grove

60506 119Aurora


60151 100Maple Park

60115 96De Kalb

60140 95Hampshire

60142 91Huntley

60120 86Elgin

60103 66Bartlett

60118 63Dundee

60102 47Algonquin

60189 45Wheaton


60502 37Aurora



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Winchester Endoscopy LibertyvilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,360

0354

1,307550231

2,442

0656

2,6181,082

446

4,802




TOTAL 2,360

3676

31,757

30

2,442

41,303

73,481

70

4,802




-2,635652,067 4,545 3,308,869 1,652 3,964,498

-0.1%16.4% 0.1% 83.5% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

008

7003202

097

Winchester Endoscopy

1870 W Winchester Road, Suite 146

Libertyville, IL 60048

Administrator

Kathryn Nor


Registered Agent


Property Owner

Winchester Medical

Legal Owner(s)

Facility Id



Kathryn Nor 224-433-6505




Exam Rooms 0

Procedure Rooms 2



TOTAL 14.00

STAFFING PATTERNS



Type of Ownership

Sole Proprietorship



Advocate Condell Medical Center, Libertyville 0




Exam Rooms 0

Procedure Rooms 2

Arkan Alrashid

John Tasiopoulos

Philip Adjei

Sean Lee

of 292 2/7/2020


Winchester Endoscopy LibertyvilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

60030 623Grayslake


60060 476Mundelein

60073 444Round Lake

60046 435Lake Villa

60031 358Gurnee


60002 198Antioch

60047 164Lake Zurich

60085 124Waukegan

60084 86Wauconda


60041 76Ingelside

60087 75Waukegan

60083 63Wadsworth

60051 61McHenry

60020 57Fox Lake

60099 56Zion


60045 39Lake Forest


60044 37Lake Bluff


60042 26Island Lake



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


AmSurg Surgery Center JolietAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 3,674

171397

1,3851,207

942

4,102

376773

2,7702,2141,643

7,776




TOTAL 3,674

02,022

252,041

140

4,102

03,553

704,129

240

7,776




-3042,937,503 474,067 8,965,865 283,806 12,660,937

0.0%23.2% 3.7% 70.8% 2.2%


0

Charity Care

Expense

0%



Reference Numbers

009

7003160

197

AmSurg Surgery Center

9980129th Infantry Drive

Joliet, IL 60435

Administrator

Sue Sorg


Registered Agent

CT Corporation

Property Owner

LB Properties

Legal Owner(s)

Facility Id



Sue Sorg 815-744-3000




Exam Rooms 0

Procedure Rooms 3



TOTAL 44.00

STAFFING PATTERNS



Type of Ownership




Amita St Joseph Medical Center 4




Exam Rooms 0

Procedure Rooms 3

Christopher Bailey

Dr. Alan Chen

Dr. Ankit Patel

Dr. Anuj Puppala

Dr. Bachar Hamad

Dr. Christy Hiser

Dr. Clyde Dawson

Dr. David Morimoto

Dr. Eligius Lelis

Dr. Eric Bass

Dr. Firdus Hashim

DR. Gaurav Singh

Dr. Lori Klemm

Dr. Majid Rassouli

Dr. Manual Corrales

Dr. Mark Danielson

Dr. Michael Cohen

Dr. Michael Gartlan

Dr. Peter Mihalakakos

Dr. Rajeev Mehta

Dr. Richard Rotnicki

Dr. Samra Hashmi

Dr. Scott Divenere

of 292 2/7/2020


AmSurg Surgery Center JolietAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


3,055.00 2,275.00TOTAL 4537 5330.00 1.17

60435 1099Joliet

60404 660Shorewood

60431 543Joliet

60586 514Plainfield

60410 471Channahon

60403 368Crest Hill

60447 329Minooka

60436 323Joliet

60450 316Morris

60441 265Lockport

60451 245New Lenox

60481 216Wilmington

60446 206Romeoville

60416 203Coal City

60544 196Plainfield

60433 183Joliet

60432 147Joliet

60408 125Braidwood

60442 95Manhattan

60421 88Elwood

60423 74Frankfort

60448 73Mokena

60439 70Lemont

60491 70Homer Glen



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 630 158 253 0.654111


of 292 2/7/2020


Center for Digestive Health BourbonnaisAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,442

0347

1,300789346

2,782

0640

2,5161,449

619

5,224




TOTAL 2,442

21,200

01,571

27

2,782

22,135

03,067

911

5,224




37,839871,280 0 3,150,974 493,704 4,553,797

0.8%19.1% 0.0% 69.2% 10.8%


4,836

Charity Care

Expense

0%



Reference Numbers

009

7002876

091

Center for Digestive Health

1615 N Convent St Ste 2

Bourbonnais, IL 60914

Administrator

Christina O'Connor


Registered Agent

Brian Scott

Property Owner

Agita, LLC

Legal Owner(s)

Facility Id



Christina O'Connor 815-602-8253




Exam Rooms

Procedure Rooms 2


Director of Nurses 1.00Registered Nurses 8.00Certified AidesOther Health Profs.Other Non-Health Profs 7.00

TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Riverside Medical Center 6St Mary's Hospital 1




Exam Rooms

Procedure Rooms 2

Ashish Shah, MD

Brian Sasso, DO

Daniel Errampalli, MD

David Sutherland, MD

Edward Jurkovic, DO

Matthew Kaplan, DO

Nikhil Bhargava, DO

Riverside Medical Center

St Mary's Hospital

Thomas O'Connor, MD

of 292 2/7/2020


Center for Digestive Health BourbonnaisAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

60901 Kankakee 2167Kankakee

60953 470Milford

60915 Kankakee 351Bradley

60954 Kankakee 204Momence

60964 Kankakee 203Saint Anne

60481 Will 144Wilmington

60468 Will 136Peotone

60970 Iroquois 112Watseka

60922 Iroquois 102Chebanse

60940 Kankakee 97Grant Park

60927 Iroquois 97Clifton

60941 91Herscher

60913 Kankakee 80Bonfield

60423 Will 64Frankfort

60938 Iroquois 53Gilman


60449 Will 45Monee

60935 Kankakee 41Essex

60401 Will 41Beecher

60408 Will 41Braidwood

60911 Iroquois 39Ashkum

60930 Iroquois 36Danforth

60958 Kankakee 34Pembroke

60951 Iroquois 31Martinton



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Deerpath Ambulatory Surgical Center, LLC MorrisAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 542

1093

248176140

667

22196454310227

1,209




TOTAL 542

10287

1368

10

667

12487

2706

20

1,209




7,569391,880 4,757 1,734,921 126,920 2,266,047

0.3%17.3% 0.2% 76.6% 5.6%


0

Charity Care

Expense

0%



Reference Numbers

009

7002785

063

Deerpath Ambulatory Surgical Center, LLC

1051 West US Route 6

Morris, IL 60450

Administrator

Michele Cheshareck, BSN, RN


Registered Agent

Keith M. Rezin, MD

Property Owner

Morris Hospital

Legal Owner(s)

Facility Id



Michele Cheshareck, BSN, RN 815-318-5614




Exam Rooms 0

Procedure Rooms 0



TOTAL 13.20

STAFFING PATTERNS



Type of Ownership




Morris Hospital and Healthcare Centers 1




Exam Rooms 0

Procedure Rooms 0

Eligius Lelis, MD

Eric T. Ortinau, MD

Keith M. Rezin, MD

Kyle T. Pearson, DPM

Majid Rassouli, DO

Morris Hospital

Rajeev Mehta, MD

Raymond J. Meyer, MD

Richard M. Rotnicki, DO

Scott Divenere, MD

of 292 2/7/2020


Deerpath Ambulatory Surgical Center, LLC MorrisAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


558.02 330.56TOTAL 1209 888.58 0.73

60450 GRUNDY 340Morris

61350 LASALLE 94Ottawa

60416 GRUNDY 86Coal City

61341 LASALLE 67Marseilles

60447 GRUNDY 63Minooka

60410 WILL 63Channahon

61364 LASALLE 59Streator


61360 LASALLE 39Seneca

60408 WILL 32Braidwood

60481 WILL 32Wilmington

60444 GRUNDY 26Mazon

60424 GRUNDY 22Gardner

60435 WILL 17Joliet

60541 KENDALL 17Newark

60551 LASALLE 16Sheridan

60407 12Braceville

60474 GRUNDY 12South Wilmington


60431 WILL 11Joliet

60404 WILL 10Shorewood

60479 GRUNDY 9Verona

60518 LASALLE 7Earlville

60436 WILL 7Joliet



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


DMG Pain Management Surgery Center, LLC NapervilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 2,596

0418

1,344845789

3,396

0786

2,4071,5181,281

5,992




TOTAL 2,596

01,343

02,053

00

3,396

02,234

03,758

00

5,992




0983,278 0 2,028,857 0 3,012,135

0.0%32.6% 0.0% 67.4% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

009

7003162

197

DMG Pain Management Surgery Center, LLC

2940 Rollingridge Road Suite 201


Administrator

Tina Sharkey


Registered Agent

Jennifer Groszek

Property Owner

Naperville Medical Prop

Legal Owner(s)

Facility Id



Rita Meyer 630-942-7964




Exam Rooms 0

Procedure Rooms 0



TOTAL 7.53

STAFFING PATTERNS



Type of Ownership








Exam Rooms 0

Procedure Rooms 0

DuPage Medical Group

of 292 2/7/2020


DMG Pain Management Surgery Center, LLC NapervilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

60564 403Naperville

60565 340Naperville

60540 305Naperville

60544 249Plainfield

60563 226Naperville

60517 188Woodridge

60137 179Glen Ellyn

60532 177Lisle

60446 158Romeoville


60586 153Plainfield

60148 151Lombard

60504 149Aurora

60585 144Plainfield

60543 143Oswego


60188 135Wheaton

60502 126Aurora

60189 121Wheaton



60490 80Bolingbrook

60561 73Darien

60139 73Glendale Heights



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000

Pain Management 5992 1509 1498 0.5030072

of 292 2/7/2020


Kendall Pointe Surgery Center, LLC OswegoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 772

8242399264181

1,094

12349736452317

1,866




TOTAL 772

85380

0480149

0

1,094

155662

0871178

0

1,866




52,367668,867 0 1,418,897 305,585 2,445,716

2.1%27.3% 0.0% 58.0% 12.5%


0

Charity Care

Expense

0%



Reference Numbers

009

7002538

093

Kendall Pointe Surgery Center, LLC

100 W. Fifth Street

Oswego, IL 60543

Administrator

Claudia Iga


Registered Agent

Greg Ingemunson

Property Owner

Legal Owner(s)

Facility Id



Claudia Iga 630-449-0085




Exam Rooms 0

Procedure Rooms 1



TOTAL 13.25

STAFFING PATTERNS



Type of Ownership




Presence Provena Mercy Medical Center, Aurora 0




Exam Rooms 0

Procedure Rooms 1

Dr. Allen Bloom

Dr. Bishop & Dr. Rappette

Dr. Brendon McCarthy

Dr. Carlos Rodriguez

Dr. Jim Wilson

Dr. John Mazur

Dr. Jose Trevino

Dr. Mario Zapata

Dr. Michael Coulson

Dr. Robert Foody

PBC Oswego, LLC

of 292 2/7/2020


Kendall Pointe Surgery Center, LLC OswegoAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,026.00 600.50TOTAL 1384 1626.50 1.18

60505 230Aurora

60506 172Aurora

60560 141Yorkville

60548 123Sandwich

60538 103Montgomery

60543 94Oswego

60545 84Plano


60564 39Naperville

60554 38Sugar Grove

60504 34Aurora

60552 32Somonauk

60540 28Naperville

61342 26Mendota

60586 23Plainfield

60565 22Naperville

60563 22Naperville

60585 22Plainfield

60134 20Geneva

60450 19Morris

60502 19Aurora

60174 18St. Charles

60551 17Sheridan

60518 16Earlville



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Oak Surgical Institute L.L.C BradleyAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,631

15335732582573

2,237

36747

1,301937847

3,868




TOTAL 1,631

2967

71,258

30

2,237

51,472

102,375

60

3,868




6,9162,024,597 13,833 3,266,590 8,512 5,320,448

0.1%38.1% 0.3% 61.4% 0.2%


0

Charity Care

Expense

0%



Reference Numbers

009

7002702

091

Oak Surgical Institute L.L.C

403 South Kennedy Drive

Bradley, IL 60915

Administrator

Mary Kohl


Registered Agent

Margaret Frogge

Property Owner

Riverside Medical Cente

Legal Owner(s)

Facility Id



Mary Kohl 815-928-9999




Exam Rooms 0

Procedure Rooms 0



TOTAL 17.00

STAFFING PATTERNS



Type of Ownership

Sole Proprietorship



Riverside Medical Center Kankakee, Illinois 8




Exam Rooms 0

Procedure Rooms 0

Oakside Corporation

Valley Investments

of 292 2/7/2020


Oak Surgical Institute L.L.C BradleyAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)

Cardiovascular 0.00 0.000 0.00 0.00Dermatology 0.00 0.000 0.00 0.00Gastroenterology 0.00 0.000 0.00 0.00General 0.00 0.000 0.00 0.00Laser Eye Surgery 0.00 0.000 0.00 0.00Neurology 0.00 0.000 0.00 0.00OB/Gynecology 0.00 0.000 0.00 0.00Ophthalmology 0.00 0.000 0.00 0.00Oral/Maxillofacial 0.00 0.000 0.00 0.00Orthopedic 855.00 1,559.001247 2414.00 1.94Otolaryngology 0.00 0.000 0.00 0.00Pain Management 250.00 1,258.002518 1508.00 0.60Plastic Surgery 0.00 0.000 0.00 0.00Podiatry 72.00 104.00103 176.00 1.71Thoracic 0.00 0.000 0.00 0.00Urology 0.00 0.000 0.00 0.00

1,177.00 2,921.00TOTAL 3868 4098.00 1.06

60914 KANKAKEE 736Bourbonnais

60901 KANKAKEE 612Kankakee

60950 KANKAKEE 344Manteno

60915 KANKAKEE 239Bradley

60481 WILL 176Wilmington

60954 KANKAKEE 125Momence

60964 KANKAKEE 111Saint Anne


60468 WILL 84Peotone

60927 IROQUOIS 81Clifton

60970 IROQUOIS 80Watseka

60401 WILL 69Beecher

60940 KANKAKEE 68Grant Park

60922 IROQUOIS 58Chebanse

60408 WILL 52Braidwood

60911 IROQUOIS 48Ashkum

60448 WILL 47Mokena

60449 WILL 45Monee

60913 KANKAKEE 42Bonfield

60416 GRUNDY 41Coal City

60451 WILL 37New Lenox

60935 KANKAKEE 35Essex


60941 KANKAKEE 31Herscher



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Plainfield Surgery Center, LLC PlainfieldAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,891

234294819369119

1,835

546587

1,680689224

3,726




TOTAL 1,891

0411

01,424

00

1,835

0745

02,981

00

3,726




0402,738 0 4,407,016 0 4,809,754

0.0%8.4% 0.0% 91.6% 0.0%


0

Charity Care

Expense

0%



Reference Numbers

009

7003135

197

Plainfield Surgery Center, LLC

24600 W 127th Street, Building C

Plainfield, IL 60585

Administrator

Karen Rouse


Registered Agent

Jennifer Groszek

Property Owner

Owned

Legal Owner(s)

Facility Id



Rita Meyer 630-942-7964




Exam Rooms 0

Procedure Rooms 1



TOTAL 18.70

STAFFING PATTERNS



Type of Ownership




Edward Hospital - Naperville 4Rush Copley Hospital - Aurora 2




Exam Rooms 0

Procedure Rooms 1

Alan Chen

Chris Olson

Craig A Smith

David J Piazza

David M Burt

DuPage Medical Group, Lt

Edward Health Ventures

Elizabeth H Harvey

Gridihar Burra

J.B. Joo

John Lombardi

Joseph J Donzetti

Neena Will

Peter Petratos

Robert R Payton

Scott M Kaszuba

Tripti Burt

of 292 2/7/2020


Plainfield Surgery Center, LLC PlainfieldAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,431.80 519.55TOTAL 2076 1951.35 0.94

60564 459Naperville

60586 296Plainfield

60544 262Plainfield

60585 259Plainfield

60565 242Naperville

60540 208Naperville

60543 160Oswego

60560 113Yorkville

60563 104Naperville

60446 98Romeoville

60440 98Bolingbrook

60490 89Bolingbrook

60504 89Aurora

60431 83Joliet

60404 77Shorewood

60502 70Aurora

60435 62Joliet

60503 56Aurora

60403 48Crest Hill

60538 39Montgomery

60517 36Woodridge

60441 33Lockport

60532 32Lisle

60447 32Minooka



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Riverside Ambulatory Surgery Center BourbonnaisAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 791

5093

206411346

1,106

119140384656598

1,897




TOTAL 791

72604

2420

80

1,106

144991

11729

220

1,897




232,6981,601,598 4,905 1,191,082 35,564 3,065,847

7.6%52.2% 0.2% 38.9% 1.2%


0

Charity Care

Expense

0%



Reference Numbers

009

7003049

091

Riverside Ambulatory Surgery Center

300 Riverside Drive, Suite 1100

Bourbonnais, IL 60914

Administrator

Carrie Stauffenberg


Registered Agent

Kyle Benoit

Property Owner

Riverside Medical Center

Legal Owner(s)

Facility Id



Robin Diepeveen 815-802-3170




Exam Rooms

Procedure Rooms



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Riverside Medical Center 3




Exam Rooms

Procedure Rooms

Dr. Elizabeth Hofmeister

Dr. Jerome Swale

Dr. Paul Rowland

Dr. Rebecca Hodulik

Dr. Renuka Ramakrishna

Dr. Robert Martin

Dr. Saroja Yalamanchili

Dr. Steven Williams

Dr. Valerie Goldfain

of 292 2/7/2020


Riverside Ambulatory Surgery Center BourbonnaisAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


984.75 744.40TOTAL 1897 1729.15 0.91

60901 Kankakee 339Kankakee

60914 Kankakee 323Bourbonnais

60950 Kankakee 200Manteno

60915 Kankakee 152Bradley

60420 Livingston 101Dwight

60964 Kankakee 90Saint Anne


60468 Will 54Peotone

60970 Iroquois 48Watseka

60940 Kankakee 47Grant Park

60922 Iroquois 37Chebanse

60927 Iroquois 35Clifton

60941 Kankakee 32Herscher

60408 Will 30Braidwood

60913 Kankakee 26Bonfield

60911 Iroquois 24Ashkum

60416 Grundy 21Coal City

60938 Iroquois 19Gilman

60966 Iroquois 13Sheldon

60953 Iroquois 11Milford

60401 Will 11Beecher

60449 Will 11Monee

60928 Iroquois 10Crescent City

60442 Will 10Manhattan



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Silver Cross Ambulatory Surgery Center New LenoxAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 782

27223297256168

971

55372546480300

1,753




TOTAL 782

1410

0553

70

971

1744

0991

170

1,753




-2,9221,049,805 0 3,286,748 29,644 4,363,275

-0.1%24.1% 0.0% 75.3% 0.7%


0

Charity Care

Expense

0%



Reference Numbers

009

7003216

197

Silver Cross Ambulatory Surgery Center

1003 Pawlak Parkway

New Lenox, IL 60451-9403

Administrator

Amy Sinder


Registered Agent

John Krepps

Property Owner

Silver Cross Hospital

Legal Owner(s)

Facility Id



Amy Sinder 815-717-1740




Exam Rooms 1

Procedure Rooms 0



TOTAL 18.00

STAFFING PATTERNS



Type of Ownership




Silver Cross Hospital, New Lenox 2




Exam Rooms 1

Procedure Rooms 0

Andros, Greggory

Antkowiak, Thomas

Burns, Thomas

Cho, Luke

Danielson, Mark

DiVerne, Scott

Gamagami, Reza

Garcini, Francisco

Garras, David

Gress, Nicole

Kichner, Paul

Kisla, Timothy

Leonard, James

Mancini, Antonio

Manecke, Ryan

Marks, Connie

Mehta, Rajeev

Merhi, Nahla

Nguyen, Thai

Pacella, Daniel

Patel, Ankit

Pierre, Gamilah

Ragauskaite, Laura

of 292 2/7/2020


Silver Cross Ambulatory Surgery Center New LenoxAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,404.00 3,697.00TOTAL 1753 5101.00 2.91



60423 Will 99Frankfort

60448 Will 91Mokena

60435 Will 84Joliet

60491 Will 63Homer Glen

60442 Will 63Manhattan


60431 Will 48Joliet


60433 Will 45Joliet

60403 Will 42Crest Hill

60432 Will 39Joliet


60404 Will 35Shorewood



60410 Will 34Channahon

60439 Cook 33Lemont

60436 Will 29Joliet

60450 Grundy 28Morris


60421 Will 24Elwood

60447 Grundy 24Minooka



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Southwest Surgery Center LLC MokenaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,748

6183664829621

2,303

7424

1,2191,3771,024

4,051




TOTAL 1,748

131,383

69793450

2,303

222,284

2511,440

540

4,051




13,3453,162,233 5,372,166 7,211,266 543,010 16,302,019

0.1%19.4% 33.0% 44.2% 3.3%


0

Charity Care

Expense

0%



Reference Numbers

009

7003201

197

Southwest Surgery Center LLC

19110 Darvin Drive, Suite A

Mokena, IL 60448

Administrator

Dawn Knight


Registered Agent

CT Corporate System

Property Owner

Med Properties

Legal Owner(s)

Facility Id



Carissa Murphy 708-478-8889




Exam Rooms

Procedure Rooms 1



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




St James Hospital, Olympia Fields 0Advocate South Suburban Hospital, Hazel Crest 0Advocate Christ Hospital, Oak Lawn 0




Exam Rooms

Procedure Rooms 1

Brian Burgess, DPM

Cary Templin, MD

Daniel Troy, MD

David Garras, MD

David Lubeck, MD

Eligius Lelis, MD

Emily Mayekar, MD

James Leonard, MD

Jason Hurbanek, MD

John Kung, MD

Neal Labana, MD

OAK Orthopedics

Patrick Sweeney, MD

Phillip Narcissi, DPM

Richard Lim, MD

Samra Hashmi

SCA Mokena, LLC

Sean Salehi, MD

of 292 2/7/2020


Southwest Surgery Center LLC MokenaAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


2,699.75 2,583.00TOTAL 3936 5282.75 1.34

60423 202Frankfort

60451 187New Lenox


60448 182Mokena



60453 124Oak Lawn

60441 112Lockport


60491 93Homer Glen


60439 79Lemont

60452 76Oak Forest

60435 73Joliet

60655 60Chicago

60450 56Morris


60466 55Park Forest

60422 52Flossmoor

60417 51Crete

60430 47Homewood

60442 46Manhattan

60465 41Palos Hills

60431 39Joliet



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000

Opthamology - Yag 115 5 2.5 0.077.5

of 292 2/7/2020


Quad City Ambulatory Surgery Center MolineAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 909

10206437280164

1,097

27420838449272

2,006




TOTAL 909

86430

4572

50

1,097

111693

251,171

60

2,006




366,1512,772,386 179,498 7,859,139 26,824 11,203,997

3.3%24.7% 1.6% 70.1% 0.2%


11,232

Charity Care

Expense

0%



Reference Numbers

010

7002520

161

Quad City Ambulatory Surgery Center

520 Valley View Drive, Suite 300

Moline, IL 61265

Administrator

Mary Ann Sears


Registered Agent

L & W Agents, Inc

Property Owner

Lacuna Inc

Legal Owner(s)

Facility Id



Dennise Nash 309-762-1952




Exam Rooms 1

Procedure Rooms 0



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Unity Point 1




Exam Rooms 1

Procedure Rooms 0

Edward Connolly

Mark Stewart

Michael Turner

R Scott Collins

Shawn Wynn

Steven Boardman

Tomas VonGillern

of 292 2/7/2020


Quad City Ambulatory Surgery Center MolineAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,007.75 812.00TOTAL 2006 1819.75 0.91

61265 ROCK ISLAND 376Moline

61201 ROCK ISLAND 258Rock Island

61244 ROCK ISLAND 189East Moline

61264 ROCK ISLAND 154Milan

61282 ROCK ISLAND 81Silvis

61240 ROCK ISLAND 78Coal Valley

61254 HENRY 78Geneseo

61241 HENRY 72Colona

52761 MUSCATINE 57

61231 MERCER 42Aledo

61273 HENRY 37Orion

61275 ROCK ISLAND 36Port Byron

61284 ROCK ISLAND 33Taylor Ridge

61281 MERCER 31Sherrard

52722 SCOTT 29

61443 HENRY 26Kewanee

61486 MERCER 18Viola

61256 ROCK ISLAND 18Hampton

61250 WHITESIDE 16Erie

61465 MERCER 16New Windsor

61232 ROCK ISLAND 15Andalusia

52806 SCOTT 15

52807 SCOTT 14

52804 SCOTT 13



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Quad City Endoscopy MolineAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,554

0153701540230

1,624

0298

1,4061,008

466

3,178




TOTAL 1,579

61795

5723150

1,599

1111,536

91,457

650

3,178




62,938761,595 29,404 740,675 15,400 1,610,012

3.9%47.3% 1.8% 46.0% 1.0%


0

Charity Care

Expense

0%



Reference Numbers

010

7003125

161

Quad City Endoscopy

4340 7th Street

Moline, IL 61265-6867

Administrator

Sreenvias Chintalapani


Registered Agent

Sreenivas Chintalapani

Property Owner

GIC Real Estate Investm

Legal Owner(s)

Facility Id



Jeanne Camara 615-843-4068




Exam Rooms 0

Procedure Rooms 2



TOTAL 10.00

STAFFING PATTERNS



Type of Ownership




Genesis Hospital Moline, IL 4




Exam Rooms 0

Procedure Rooms 2

Bettaiah Gowda

Shshinath Chandrahasego

Sreenivas Chintalapani

of 292 2/7/2020


Quad City Endoscopy MolineAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

61265 701Moline

61201 491Rock Island

99999 425

61244 320East Moline

61264 199Milan

61240 133Coal Valley

61241 109Colona

61282 108Silvis

61254 79Geneseo

61275 55Port Byron

61281 53Sherrard

61273 42Orion

61284 41Taylor Ridge

61232 26Andalusia

61279 23Reynolds

61486 22Viola

61259 22Illinois City

61242 19Cordova

61257 19Hillsdale

61443 18Kewanee

61465 16New Windsor

61250 15Erie

52722 15

61263 14Matherville



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


RSC Illinois, LLC MolineAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 3,769

217882

1,7331,057

570

4,459

3821,4783,1552,1071,106

8,228




TOTAL 4,467

464912125

2,263131

3,778

1,3731,986

2164,645

232

8,245




138,770963,651 246,210 4,244,139 614,622 6,207,392

2.2%15.5% 4.0% 68.4% 9.9%


0

Charity Care

Expense

0%



Reference Numbers

010

7003136

161

RSC Illinois, LLC

545 Valley View Drive

Moline, IL 61265

Administrator

Emily Whipple


Registered Agent

National Registered Agents, In

Property Owner

Valley View Realty, LLL

Legal Owner(s)

Facility Id



Kathleen DePalo 615-760-6593




Exam Rooms 1

Procedure Rooms 5


Director of NursesRegistered Nurses 15.36Certified AidesOther Health Profs. 9.84Other Non-Health Profs

TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




Unity Point- Rock Island 6




Exam Rooms 1

Procedure Rooms 5

Brian Engebrecht, MD

Dr. Amit Patel, P LLC

Morris Gist, MD

of 292 2/7/2020


RSC Illinois, LLC MolineAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


959.50 414.76TOTAL 910 1374.26 1.51

61265 1656Moline

61201 1388Rock Island

61244 916East Moline

61264 433Milan

61282 357Silvis

61254 303Geneseo

61240 266Coal Valley

61241 260Colona

52722 231

61231 151Aledo

61275 144Port Byron

61273 139Orion

52804 124

61281 113Sherrard

61284 110Taylor Ridge

52806 109

61256 76Hampton

61238 73Cambridge

52803 72

61250 67Erie

52807 64

52761 55

52753 49

61239 46Carbon Cliff



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Bel-Clair Ambulatory Surgical Treatment Center, L BellevilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 723

048

423294111

876

092

766543198

1,599




TOTAL 723

0215

0648130

876

0394

01,181

240

1,599




0174,599 0 1,060,894 118,626 1,354,119

0.0%12.9% 0.0% 78.3% 8.8%


0

Charity Care

Expense

0%



Reference Numbers

011

7001811

163

Bel-Clair Ambulatory Surgical Treatment Center, Lt

325 West Lincoln St

Belleville, IL 62220

Administrator

David R Horace


Registered Agent

David R Horace

Property Owner

West Lincoln Bldg,

Legal Owner(s)

Facility Id



DAVID R HORACE 618-235-2299




Exam Rooms 1

Procedure Rooms 0



TOTAL

STAFFING PATTERNS


Nurse Anesthetists

Type of Ownership




St Elizabeth's Hospital 0Memorial Hospital 0




Exam Rooms 1

Procedure Rooms 0

David R Horace

Stephen A Schmidt

of 292 2/7/2020


Bel-Clair Ambulatory Surgical Treatment Center, L BellevilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


453.05 533.00TOTAL 1599 986.05 0.62

62221 157Belleville

62226 156Belleville

62269 146O'Fallon

62220 117Belleville

62223 107Belleville

62258 104Mascoutah

62243 78Freeburg

62208 67Fairview Heights

62260 61Millstadt

62265 52New Baden

62285 49Smithton

62234 42Collinsville

62254 35Lebanon

62264 29New Athens

62236 22Columbia

62278 22Red Bud

62271 21Okawville

62294 19Troy

62293 19Trenton

62298 18Waterloo

62249 16Highland

62215 16Albers

62257 15Marissa

62206 13Cahokia



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Belleville Surgery Center, LTD dba Physcians' Sur BellevilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 601

013438515147

717

022072628587

1,318




TOTAL 601

10920667

33500

717

167380151618

20

1,318




56,490192,873 80,716 514,103 1,120 845,302

6.7%22.8% 9.5% 60.8% 0.1%


0

Charity Care

Expense

0%



Reference Numbers

011

7003191

163

Belleville Surgery Center, LTD dba Physcians' Surg

311 West Lincoln, Ste 300


Administrator Date Complete5/6/2019

Registered Agent


Property Owner

Belleville Family Medical

Legal Owner(s)

Facility Id



Kevin Hamers 319-594-1131




Exam Rooms 0

Procedure Rooms 1



TOTAL 0.00

STAFFING PATTERNS



Type of Ownership




Memorial Hospital, Belleville, IL 2




Exam Rooms 0

Procedure Rooms 1

Aaron Greenspan, MD

Carl Lee, MD

Christopher Dugan, DPM

Eric Whittenburg, DPM

Kim Reichert, DPM

Mitchell Needleman, DPM

Murray McGrady, MD

of 292 2/7/2020


Belleville Surgery Center, LTD dba Physcians' Sur BellevilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


382.50 710.00TOTAL 1318 1092.50 0.83

62269 182O'Fallon

62226 150Belleville

62221 133Belleville


62220 94Belleville

62223 74Belleville


62258 43Mascoutah

62260 30Millstadt

62254 28Lebanon

62040 25Granite City

62285 23Smithton

62225 22Belleville

62243 21Freeburg

62294 20Troy

62206 19Cahokia

62264 18New Athens

62203 18East St. Louis

62265 17New Baden

62249 16Highland


62236 15Columbia

62025 14Edwardsville

62204 13Washington Park



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Belleville Surgical Center, LTD BellevilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 217

2474

11212077

407

6498

167180115

624




TOTAL 217

918345

16460

407

13272

63266

100

624




7,351274,190 130,170 238,265 45,482 695,458

1.1%39.4% 18.7% 34.3% 6.5%


0

Charity Care

Expense

0%



Reference Numbers

011

7001175

163

Belleville Surgical Center, LTD

28 N. 64th Street


Administrator Date Complete5/6/2019

Registered Agent


Property Owner

Legal Owner(s)

Facility Id



Kevin Hamers 319-594-1131




Exam Rooms 0

Procedure Rooms 0



TOTAL 0.00

STAFFING PATTERNS



Type of Ownership




Memorial Hospital, Belleville, IL 1




Exam Rooms 0

Procedure Rooms 0

Aaron Greenspan, MD

Carl Lee, MD

Christopher Dugan, DPM

Eric Whittenburg, DPM

Kim Reichert, DPM

Mitchell Needleman, DPM

Murray McGrady, MD

of 292 2/7/2020


Belleville Surgical Center, LTD BellevilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


258.25 303.50TOTAL 624 561.75 0.90

62269 89O'Fallon

62221 65Belleville

62226 55Belleville

62258 33Mascoutah

62220 29Belleville


62223 25Belleville

62260 20Millstadt


62243 16Freeburg


62225 11Belleville

62298 10Waterloo

62285 10Smithton

62232 10Caseyville

62265 9New Baden

62040 9Granite City

62293 8Trenton

62233 8Chester


62264 7New Athens

62010 6Bethalto

62249 6Highland

62257 6Marissa



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Edwardsville Ambulatory Surgery Center, LLC Glen CarbonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 801

83165421245143

1,057

176282724410266

1,858




TOTAL 801

3524142

716230

1,057

63402

841,281

280

1,858




350,8272,056,599 656,611 6,282,853 28,657 9,375,547

3.7%21.9% 7.0% 67.0% 0.3%


0

Charity Care

Expense

0%



Reference Numbers

011

7002504

119

Edwardsville Ambulatory Surgery Center, LLC

12 Ginger Creek Parkway

Glen Carbon, IL 62034

Administrator

Ed Cunningham


Registered Agent


Property Owner

Legal Owner(s)

Facility Id



Michelle Looney 618-656-8200




Exam Rooms 0

Procedure Rooms 1



TOTAL 13.50

STAFFING PATTERNS



Type of Ownership




Gateway Regional Med Ctr, Granite City 0Anderson Hospital, Maryville 0




Exam Rooms 0

Procedure Rooms 1

Alan Gitersonke, DPM

Barry Feinberg, MD

Granite City Ill Hospital

Michael Jones, MD

R. Craig McKee, MD

Rachel Feinberg, MD

Ronald Gould, MD

Tong Zhu, MD

of 292 2/7/2020


Edwardsville Ambulatory Surgery Center, LLC Glen CarbonAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


566.25 565.25TOTAL 1858 1131.50 0.61




62034 113Glen Carbon

62002 103Alton

62294 102Troy

62249 74Highland

62062 59Maryville

62035 53Godfrey

62010 47Bethalto

62269 34O'Fallon

62095 31Wood River

62024 28East Alton

62088 26Staunton

62281 23Saint Jacob

62052 20Jerseyville

62097 20Worden

62221 19Belleville

62232 19Caseyville

62061 18Marine


62001 14Alhambra

62246 14Greenville

62254 11Lebanon



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0001


of 292 2/7/2020


Eye Surgery Center LLC BellevilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,681

049

5401,1201,012

2,721

0104903

1,7331,662

4,402




TOTAL 1,681

772,062

3500790

2,721

1313,213

31868159

0

4,402




56,0462,298,579 20,624 715,979 98,170 3,189,398

1.8%72.1% 0.6% 22.4% 3.1%


0

Charity Care

Expense

0%



Reference Numbers

011

7003206

163

Eye Surgery Center LLC

3990 North Illinois Street, Lower Level

Belleville, IL 62226-1919

Administrator

Nancy A. Mueth


Registered Agent


Property Owner

CHCT, Illinois LLC

Legal Owner(s)

Facility Id



Nancy A. Mueth 618-235-3100




Exam Rooms 1

Procedure Rooms 2



TOTAL 11.00

STAFFING PATTERNS



Type of Ownership




St. Elizabeth's Hospital Shiloh 0Memorial Hospital Belleville 0




Exam Rooms 1

Procedure Rooms 2

Eye Surgery Center, LLC

of 292 2/7/2020


Eye Surgery Center LLC BellevilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


1,243.00 629.00TOTAL 3434 1872.00 0.55

62226 396Belleville

62269 381O'Fallon

62221 327Belleville

62220 232Belleville

62223 232Belleville


62260 109Millstadt

62243 107Freeburg

62298 105Waterloo

62258 103Mascoutah


62206 82Cahokia

62232 73Caseyville

62254 73Lebanon

62278 68Red Bud

62285 68Smithton

62230 65Breese

62233 63Chester


62249 60Highland

62265 60New Baden


62236 54Columbia

62286 52Sparta



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 968 500 42 0.565422


of 292 2/7/2020


Metroeast Endoscopic Surgery Center, LLC Fairview HeightsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,534

1559

1,169351149

2,229

1818

1,979681284

3,763




TOTAL 1,534

536650180855

80

2,229

8231,171

2951,462

120

3,763




303,081461,915 131,344 1,439,555 7,867 2,343,762

12.9%19.7% 5.6% 61.4% 0.3%


0

Charity Care

Expense

0%



Reference Numbers

011

7003185

163

Metroeast Endoscopic Surgery Center, LLC

5023 North Illinois Street

Fairview Heights, IL 62208

Administrator

Laurie Craig


Registered Agent

Shakeel Ahmed

Property Owner

Legal Owner(s)

Facility Id



Laurie Craig 618-239-0678




Exam Rooms 0

Procedure Rooms 1



TOTAL 12.00

STAFFING PATTERNS



Type of Ownership




Gateway Regional Medical Center 0Memorial 0




Exam Rooms 0

Procedure Rooms 1

of 292 2/7/2020


Metroeast Endoscopic Surgery Center, LLC Fairview HeightsAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

62269 449O'Fallon

62226 311Belleville

62221 308Belleville




62223 161Belleville

62220 139Belleville

62258 122Mascoutah

62206 91Cahokia

62232 89Caseyville




62254 69Lebanon


62207 50Alorton

62260 50Millstadt

62294 49Troy

62060 43Madison


62298 39Waterloo

62255 39Lenzburg

62034 34Glen Carbon



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


Monroe County Surgical Center WaterlooAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 442

1849

17210173

413

3899

388198132

855




TOTAL 442

8132

7266

00

413

11242

16584

20

855




18,485379,994 0 826,281 2,957 1,227,717

1.5%31.0% 0.0% 67.3% 0.2%


0

Charity Care

Expense

0%



Reference Numbers

011

7003194

133

Monroe County Surgical Center

501 Hamacher

Waterloo, IL 62298

Administrator

Larry Parsley


Registered Agent

C T Corporation Systems

Property Owner

American Healthcare

Legal Owner(s)

Facility Id



Larry Parsley 618-939-1001




Exam Rooms 1

Procedure Rooms 0



TOTAL 5.00

STAFFING PATTERNS



Type of Ownership




Red Bud Regional Hospital 1




Exam Rooms 1

Procedure Rooms 0

Christopher Vulin

Donald Unwin

Gregory Randel

Ketan Shah

Michael Kirk

Red Bud Regional Hospital

Ricardo Rao

Robert Bell

Ryan Pitts

William Reilly

of 292 2/7/2020


Monroe County Surgical Center WaterlooAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


391.76 295.78TOTAL 855 687.54 0.80

62298 Monroe 363Waterloo

62278 Randolph 115Red Bud

62236 Monroe 111Columbia

62277 Randolph 32Prairie Du Rocher

62239 Saint Clair 23Dupo

62244 Monroe 23Fults

62295 Monroe 22Valmeyer

62260 Saint Clair 19Millstadt

62264 Saint Clair 16New Athens

62242 Randolph 15Evansville

62286 Saint Clair 15Sparta

62285 Saint Clair 10Smithton

62240 Saint Clair 8East Carondelet

62206 Saint Clair 7Cahokia

62241 Randolph 7Ellis Grove

62226 Saint Clair 6Belleville

62233 Randolph 6Chester


62214 Washington 4Addieville

62269 Saint Clair 4O'Fallon

62288 Randolph 4Steeleville

62234 Madison 3Collinsville

62272 Randolph 3Percy

62237 Randolph 2Coulterville



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE



Laser Eye 0 0 0 0.0000


of 292 2/7/2020


NovaMed Eye Surgery Center of Maryville, LLC MaryvilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 1,342

024

466872679

2,041

033

7841,4001,166

3,383




TOTAL 1,342

821,562

2389

60

2,041

1422,514

20691

160

3,383




66,6732,390,951 43,646 1,668,091 -152,134 4,017,227

1.7%59.5% 1.1% 41.5% -3.8%


0

Charity Care

Expense

0%



Reference Numbers

011

7002132

119

NovaMed Eye Surgery Center of Maryville, LLC

12 Professional Park Drive

Maryville, IL 62062

Administrator

Nicole Will


Registered Agent

Jennifer Baldock

Property Owner

S&D Joint Venture

Legal Owner(s)

Facility Id



Nicole Will 618-288-7483




Exam Rooms 0

Procedure Rooms 1



TOTAL 8.00

STAFFING PATTERNS



Type of Ownership




Anderson Hospital, Maryville 1Gateway Hospital, Granite City 0




Exam Rooms 0

Procedure Rooms 1

Bart Jones, MD

Eric Wigton, MD

Jeff Maher, MD

Melissa Kiel, MD

Michael Jones, MD

NovaMed Mgmt Services

of 292 2/7/2020


NovaMed Eye Surgery Center of Maryville, LLC MaryvilleAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

62040 Madison 299Granite City

62234 Madison 219Collinsville

62025 Madison 175Edwardsville

62294 Madison 96Troy

62062 Madison 94Maryville

62249 Madison 89Highland

62034 Madison 85Glen Carbon

62002 Madison 81Alton

62269 Saint Clair 61O'Fallon

62095 Madison 45Wood River

62010 Madison 42Bethalto


62035 Madison 40Godfrey


62088 Macoupin 33Staunton

62232 Saint Clair 25Caseyville

62208 Saint Clair 23Fairview Heights


62060 Madison 21Madison

62024 Madison 20East Alton

62201 Saint Clair 20East St. Louis

62097 Madison 18Worden

62246 Bond 18Greenville

62258 Saint Clair 17Mascoutah



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE


Cataract Extraction 2779 694.75 277.9 0.35972.65

Cornea Transplant 17 17 5.66 1.3322.66


of 292 2/7/2020


The Hope Clinic for Women, Ltd Granite CityAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018


TOTAL 0

13,751

1400

3,766

13,751

1400

3,766




TOTAL 0

0000

3,7660

3,766

0000

3,7660

3,766




00 0 0 1,570,698 1,570,698

0.0%0.0% 0.0% 0.0% 100.0%


0

Charity Care

Expense

0%



Reference Numbers

011

7001084

119

The Hope Clinic for Women, Ltd

1602 21st Street

Granite City, IL 62040

Administrator

Erin King, MD


Registered Agent

Northwest Registered Agent Ser

Property Owner

United Realty LLC

Legal Owner(s)

Facility Id



Debbie Wiehardt 628-451-5722




Exam Rooms 1

Procedure Rooms 2



TOTAL 10.00

STAFFING PATTERNS



Type of Ownership




Barnes Jewis Hospital, St. Louis, MO 3Gateway Regional Medical Center Granite City, Il 1




Exam Rooms 1

Procedure Rooms 2

Hector Zevallos

of 292 2/7/2020


The Hope Clinic for Women, Ltd Granite CityAMBULATORY SURGICAL TREATMENT CENTER PROFILE-2018





SURGERY PREP

AND CLEAN-UP

TIME (HOURS)SURGERY



(HOURS)


0.00 0.00TOTAL 0 0.00 0.00

63136 106

62002 97Alton

63033 92


62206 74Cahokia

63031 69

62221 67Belleville

62226 65Belleville

63138 65

63137 64


63135 59

62207 53Alorton

62901 52Carbondale

62269 47O'Fallon

63121 46

63116 44


63112 43

63042 41


63118 39

63114 38

63034 38



PREP ANDCLEAN-UP

TIME (HOURS)SURGERY



PROCEDURE


Elective Termination 3766 314 628 0.25942


Laser Eye 0 0 0 0.0000

of 292 2/7/2020


AMBULATORY SURGICAL TREATMENT CENTER PROFILE …...SURGERY AREA SURGERIES TOTAL OPERATING ROOM...

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Transcript of AMBULATORY SURGICAL TREATMENT CENTER PROFILE …...SURGERY AREA SURGERIES TOTAL OPERATING ROOM...