NPIMap

Organization Active NPI

Anthony J. Geroulis, MD., S.C

Doing business as N Shore Cntr Facial Plastic & Cosmetic Surg.

  • Otolaryngology Physician
  • Northfield, IL
National Provider Identifier
1063801033
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036050050 Issued in IL
Legal business name
ANTHONY J. GEROULIS, MD., S.C
Doing business as
N Shore Cntr Facial Plastic & Cosmetic Surg.
Practice address
330 West Frontage Rd
Northfield, IL 60093
Phone
(847) 441-4441
Fax
(847) 784-9744
NPI assigned
Jan 14, 2015
Last updated
Jan 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Authorized official

Name
Anthony James Geroulis, M.D.NPI 1982769717
Title
Medical Director
Phone
(847) 441-4441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 036050050 IL Primary

Addresses

Primary practice location

330 West Frontage Rd
Northfield, IL 60093

Mailing address

330 West Frontage Rd
Northfield, IL 60093
Phone (847) 441-4441

Other names 1

  • N Shore Cntr Facial Plastic & Cosmetic Surg. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Anthony J Geroulis MD SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421193600000",
    "number": "1063801033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WEST FRONTAGE RD",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "60093",
            "telephone_number": "847-441-4441",
            "fax_number": "847-784-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 WEST FRONTAGE RD",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "60093",
            "telephone_number": "847-441-4441",
            "fax_number": "847-784-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY J. GEROULIS, MD., S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-14",
        "last_updated": "2015-01-14",
        "status": "A",
        "authorized_official_last_name": "GEROULIS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "847-441-4441",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036050050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "N Shore Cntr Facial Plastic & Cosmetic Surg.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Northfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.