# HSSI MCO SPV LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154912202
- **Authorized official:** AMY OWENS (DIRECTOR , FINANCE)
- **Authorized official phone:** (815) 300-7106

## Contact information

- **Practice address:** 1851 SILVER CROSS BLVD, STE 110, NEW LENOX, IL 60451
- **Practice address phone:** (815) 300-3060
- **Mailing address:** 1900 SILVER CROSS BLVD, NEW LENOX, IL 60451-9509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207T00000X | Neurological Surgery Physician | — | NULL | — |
| 207T00000X | Neurological Surgery Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 02/01/2021
- **Last updated:** 02/01/2021