Organization Active NPI

Gynecologic Specialists of Northwestern, S.C.

  • Gynecology Physician
  • Chicago, IL
National Provider Identifier
1013014042
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
GYNECOLOGIC SPECIALISTS OF NORTHWESTERN, S.C.
Practice address
680 N Lake Shore Dr
Suite117
Chicago, IL 60611-4546
Phone
(312) 654-1166
Fax
(312) 654-5288
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Authorized official

Name
Dr. Jane E Blumenthal, MD
Title
Owner/Treasurer
Phone
(312) 654-1166

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

680 N Lake Shore Dr
Suite117
Chicago, IL 60611-4546

Mailing address

190 E Delaware PL
Chicago, IL 60611-1814
Phone (312) 654-5292

Other names 1

  • Obstetric and Gynocologic Specialists of Northwestern S.C. Former legal business name

National Provider Directory

National Provider Directory

Locations

680 N Lake Shore Dr
Ste 11
Chicago, IL 60611
Phone (312) 503-6000

190 E Delaware Pl
Chicago, IL 60611
Phone (312) 944-0063

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1013014042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E DELAWARE PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606111814",
            "telephone_number": "312-654-5292",
            "fax_number": "312-654-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE117",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-654-1166",
            "fax_number": "312-654-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GYNECOLOGIC SPECIALISTS OF NORTHWESTERN, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "BLUMENTHAL",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/TREASURER",
        "authorized_official_telephone_number": "312-654-1166",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Obstetric and Gynocologic Specialists of Northwestern S.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Mar 4, 2013; 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.