NPIMap

Organization Active NPI

North Shore Associates in Gynecology and Obstetrics, S.C.

  • Specialist
  • Evanston, IL
National Provider Identifier
1023139136
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
042-006555 Issued in IL
Legal business name
NORTH SHORE ASSOCIATES IN GYNECOLOGY AND OBSTETRICS, S.C.
Practice address
2500 Ridge Ave
Suite 301
Evanston, IL 60201-2455
Phone
(847) 475-1224
Fax
(847) 475-0150
NPI assigned
Apr 3, 2007
Last updated
Sep 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Authorized official

Name
Dr. Hani Jacob Saleh, M.D.NPI 1720089923
Title
President
Phone
(847) 475-1224

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 042-006555 IL Primary

Addresses

Primary practice location

2500 Ridge Ave
Suite 301
Evanston, IL 60201-2455

Mailing address

2500 Ridge Ave
Suite 301
Evanston, IL 60201-2455
Phone (847) 475-1224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525000198 IL Part B Supplier - Clinic/Group Practice 6305827635 Receives reassigned benefits from 8 practitioners
Practice locations: Glenview, IL; Wilmette, IL

National Provider Directory

National Provider Directory

Locations

2500 Ridge Ave
Ste 301
Evanston, IL 60201
Phone (847) 475-1224

2500 Ridge Ave
Ste 303
Evanston, IL 60201
Phone (847) 475-1224

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253145600000",
    "number": "1023139136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 RIDGE AVE",
            "address_2": "SUITE 301",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012455",
            "telephone_number": "847-475-1224",
            "fax_number": "847-475-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 RIDGE AVE",
            "address_2": "SUITE 301",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012455",
            "telephone_number": "847-475-1224",
            "fax_number": "847-475-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE ASSOCIATES IN GYNECOLOGY AND OBSTETRICS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2009-09-17",
        "status": "A",
        "authorized_official_last_name": "SALEH",
        "authorized_official_first_name": "HANI",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-475-1224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "042-006555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.