BARIATRIC SPECIALISTS OF ILLINOIS — NPI 1740201755 (Licensed & Credentialed Allopathic & Osteopathic Physicians

CMS-1500 Box 24J / 33a • NPI

1740201755

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

208200000X (CMS 02)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery

Box 32 Service Location & ZIP+4

1625 S STATE ST, BELVIDERE, IL, 61008-5907

✓ 9-Digit EDI 837 ZIP+4 (61008-5907)

Practice Phone & Referral Fax

(815) 544-1360

Fax: (815) 547-5394

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1740201755 (BARIATRIC SPECIALISTS OF ILLINOIS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1740201755` (NPI-2 Organization / Facility)
Provider / Legal Name	BARIATRIC SPECIALISTS OF ILLINOIS
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery NUCC Code: `208200000X` (Plastic Surgery)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1625 S STATE ST, BELVIDERE, IL, 61008-5907
Practice Telephone / Fax	Tel: (815) 544-1360 \| Fax: (815) 547-5394
Administrative Mailing Address	135 S PROSPECT ST, YPSILANTI, MI, 48198-7914
Enumeration & Last Sync	Enumerated: 2006-07-22 \| CMS Record Updated: 2025-09-11
Authorized Official	LAURENCE LENZ (Executive Vice President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1625 S STATE ST, BELVIDERE, IL, 61008-5907

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Plain-English Taxonomy & CMS Crosswalk (208200000X)

What Does Taxonomy Code 208200000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208200000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 24 (Physician/Plastic and Reconstructive Surgery)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Plastic Surgery for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BARIATRIC SPECIALISTS OF ILLINOIS)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207R00000X` — Internal Medicine Plain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)	State: N/A \| License: `Verified` \| Primary: Secondary
`208600000X` — Surgery Plain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)	State: N/A \| License: `Verified` \| Primary: Secondary
`208200000X` — Plastic Surgery Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BARIATRIC SPECIALISTS OF ILLINOIS (NPI #1740201755)