NPIMap

Organization Active NPI

Northshore University Healthsystem Faculty Practice Associates

  • Anesthesiology Physician
  • Skokie, IL
National Provider Identifier
1013155167
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0000646 Issued in IL
Legal business name
NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES
Practice address
9701 Knox Ave
Suite 103
Skokie, IL 60076-1256
Phone
(847) 933-6974
Fax
(847) 933-6044
NPI assigned
Jan 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2015

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

Authorized official

Name
Dr. Joseph Golbus, M.D.
Title
President
Phone
(847) 570-2503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 0000646 IL Primary

Addresses

Primary practice location

9701 Knox Ave
Suite 103
Skokie, IL 60076-1256

Mailing address

9701 Knox Ave
Suite 103
Skokie, IL 60076-1256
Phone (847) 933-6974

Other identifiers 2

IdentifierTypeStateIssuer
DC2634OtherILRAILROAD
01623422OtherILBCBS

Other names 1

  • Knox Pain Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Endeavor Health Medical Group4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1013155167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 KNOX AVE",
            "address_2": "SUITE 103",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761256",
            "telephone_number": "847-933-6974",
            "fax_number": "847-933-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 KNOX AVE",
            "address_2": "SUITE 103",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761256",
            "telephone_number": "847-933-6974",
            "fax_number": "847-933-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-28",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "GOLBUS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-570-2503",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "0000646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "DC2634",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01623422",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knox Pain Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; 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.