NPIMap

Organization Active NPI

Nova Physician Group PLLC

  • Primary Care Clinic/Center
  • Chicago, IL
National Provider Identifier
1003662057
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
NOVA PHYSICIAN GROUP PLLC
Practice address
1819 N Harlem Ave
Chicago, IL 60707-3716
Phone
(773) 589-4385
Fax
(872) 228-8601
NPI assigned
Apr 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Terrence Morton Jr.
Title
Sr. Medical Director
Phone
(312) 733-9730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1819 N Harlem Ave
Chicago, IL 60707-3716

Mailing address

30 W Monroe St Ste 1200
Chicago, IL 60603-2420
Phone (773) 352-1515

National Provider Directory

National Provider Directory
Tax ID family
Nova Physician Group PLLC18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

1819 N Harlem Ave
Chicago, IL 60707
Phone (773) 237-8927

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1003662057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MONROE ST STE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032420",
            "telephone_number": "773-352-1515",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 N HARLEM AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607073716",
            "telephone_number": "773-589-4385",
            "fax_number": "872-228-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA PHYSICIAN GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "MORTON",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_title_or_position": "SR. MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "312-733-9730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.