North Shore Eye and Vascular SC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036049793 Issued in IL

Legal business name

NORTH SHORE EYE AND VASCULAR SC

Practice address

236 E Irving Park Rd
Wood Dale, IL 60191-2099

Phone

(847) 590-1500

Fax

(847) 590-1502

NPI assigned

Sep 5, 2013

Organization subpart

No

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

Authorized official

Name

Dominic Tolitano, M.D.

Title

Owner

Phone

(847) 590-1500

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378339200000",
    "number": "1013342401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 E IRVING PARK RD",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601912099",
            "telephone_number": "847-590-1500",
            "fax_number": "847-590-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 E IRVING PARK RD",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601912099",
            "telephone_number": "847-590-1500",
            "fax_number": "847-590-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE EYE AND VASCULAR SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-05",
        "last_updated": "2013-09-05",
        "status": "A",
        "authorized_official_last_name": "TOLITANO",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-590-1500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036049793",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036067328",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.