Active NPI
Richard Sherbahn, MD
- Obstetrics & Gynecology Physician
- Gurnee, IL
National Provider Identifier
1033226790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 03608G403
- Practice address
- 30 Tower Court
Suite F
Gurnee, IL 60031 - Phone
- (847) 662-1818
- Fax
- (847) 662-3001
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 03608G403 | IL | Primary |
Addresses
Primary practice location
30 Tower Court
Suite F
Gurnee, IL 60031
Mailing address
30 Tower Court
Suite F
Gurnee, IL 60031
Phone (847) 662-1818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4908143 | Other | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03608G403 | IL | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033226790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 TOWER COURT",
"address_2": "SUITE F",
"city": "GURNEE",
"state": "IL",
"postal_code": "60031",
"telephone_number": "847-662-1818",
"fax_number": "847-662-3001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 TOWER COURT",
"address_2": "SUITE F",
"city": "GURNEE",
"state": "IL",
"postal_code": "60031",
"telephone_number": "847-662-1818",
"fax_number": "847-662-3001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERBAHN",
"first_name": "RICHARD",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "03608G403",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4908143",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Gurnee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.