NPIMap

Organization Active NPI

Northwest Suburban Urology Associates SC

  • Urology Physician
  • Elk Grove Village, IL
National Provider Identifier
1013089481
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
NORTHWEST SUBURBAN UROLOGY ASSOCIATES SC
Practice address
800 Biesterfield Rd
Suite 303
Elk Grove Village, IL 60007-7312
Phone
(847) 593-0404
Fax
(847) 593-1509
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Authorized official

Name
Mrs. Judith Jerome
Title
Practice Manager
Phone
(847) 871-4772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

800 Biesterfield Rd
Suite 303
Elk Grove Village, IL 60007-7312

Mailing address

800 Biesterfield Rd
Suite 303
Elk Grove Village, IL 60007-7312
Phone (847) 593-0404

Other identifiers 1

IdentifierTypeStateIssuer
946350OtherILPTAN

National Provider Directory

National Provider Directory

Locations

1614 W Central Rd
Ste 202
Arlington Heights, IL 60005
Phone (847) 253-7777

810 Biesterfield Rd
Ste 303
Elk Grove Vlg, IL 60007
Phone (847) 593-0404

800 Biesterfield Rd
Ste 303
Elk Grove Vlg, IL 60007
Phone (847) 427-7100

Practitioners & affiliated clinicians

Practitioners 10

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": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419811200000",
    "number": "1013089481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "SUITE 303",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600077312",
            "telephone_number": "847-593-0404",
            "fax_number": "847-593-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "SUITE 303",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600077312",
            "telephone_number": "847-593-0404",
            "fax_number": "847-593-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SUBURBAN UROLOGY ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2014-12-29",
        "status": "A",
        "authorized_official_last_name": "JEROME",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "847-871-4772",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "946350",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; 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.