Northwest Suburban Family Physician LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTHWEST SUBURBAN FAMILY PHYSICIAN LLC

Practice address

7900 N Milwaukee Ave
Ste 234
Niles, IL 60714-3244

Phone

(847) 966-1750

Fax

(847) 966-2724

NPI assigned

Mar 28, 2006

Organization subpart

No

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

Authorized official

Name

Albert A Olorvida, MD

Title

Organizer

Phone

(847) 966-1750

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Debra Joan Haley, PHD

  • Clinical Psychologist
  • Niles, IL
  • NPI 1306948690
  NPD (past)

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1073573473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE",
            "address_2": "STE 234",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143244",
            "telephone_number": "847-966-1750",
            "fax_number": "847-966-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE",
            "address_2": "STE 234",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143244",
            "telephone_number": "847-966-1750",
            "fax_number": "847-966-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SUBURBAN FAMILY PHYSICIAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "OLORVIDA",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ORGANIZER",
        "authorized_official_telephone_number": "847-966-1750",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Niles, IL
• Providers in Niles, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.