Gold Coast Internal Medicine

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

GOLD COAST INTERNAL MEDICINE

Practice address

3000 N Halsted Street
Suite 303
Chicago, IL 60657-5190

Phone

(773) 525-1900

Fax

(773) 525-1911

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Waldo Emerson Harvey Jr., M.D.NPI 1942392055

Title

President

Phone

(773) 525-1900

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Waldo Emerson Harvey Jr., MD

  • Specialist
  • Chicago, IL
  • NPI 1942392055
  NPD (past) Authorized official

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053403162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED STREET",
            "address_2": "SUITE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575190",
            "telephone_number": "773-525-1900",
            "fax_number": "773-525-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED STREET",
            "address_2": "SUITE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575190",
            "telephone_number": "773-525-1900",
            "fax_number": "773-525-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "WALDO",
        "authorized_official_middle_name": "EMERSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-525-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1623742",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "72761",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gold Coast Anesthesia PLLC
• Gold Coast Bariatrics LLC
• Gold Coast Clinical Associates Inc
• Gold Coast Diagnostic Services, Inc.
• Gold Coast Gynecology Surgery SC
• Gold Coast Orthopaedic and Spine Surgery S C
• Gold Coast Orthopaedic and Spine Surgery SC
• Gold Coast Osteopathic, PSC
• Gold Coast Osteopathic, PSC
• Gold Coast Plastic Surgery LLC

• Specialist in Chicago, IL
• Providers in Chicago, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.