Concourse Medical Associates, LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036026661 Issued in IL

Legal business name

CONCOURSE MEDICAL ASSOCIATES, LTD

Practice address

5410 Warren St
Morton Grove, IL 60053-3639

Phone

(847) 583-0939

Fax

(847) 583-0945

NPI assigned

Jul 16, 2006

Organization subpart

No

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

Authorized official

Name

H Edward Klemptner, M.D.

Title

President

Phone

(847) 583-0939

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251417600000",
    "number": "1043237969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388320",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606388320",
            "telephone_number": "773-767-4600",
            "fax_number": "773-767-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 WARREN ST",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600533639",
            "telephone_number": "847-583-0939",
            "fax_number": "847-583-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCOURSE MEDICAL ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2009-08-28",
        "status": "A",
        "authorized_official_last_name": "KLEMPTNER",
        "authorized_official_first_name": "H",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-583-0939",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036026661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036026661",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "01607179",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00134710",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maris Clinebell
• Katie Coakley, OTR/L
• Albert Cohen, MSW LCSW
• Common Threads Counseling Center LLC
• Concentra Health Services, Inc.
• Cole Connington, PA
• Consultants in Gynecology, S.C.
• Mary Elizabeth Conte, M.D.
• Maria Alejandra Contecha
• Gordon Cotell, M.D.

• Internal Medicine Physician in Morton Grove, IL
• Providers in Morton Grove, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; 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.