Northstar Integrated Health & Physical Medicine Center, S.C.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209009686 Issued in IL

Legal business name

NORTHSTAR INTEGRATED HEALTH & PHYSICAL MEDICINE CENTER, S.C.

Practice address

4513 Lincoln Ave
#212
Lisle, IL 60532-1289

Phone

(630) 795-1889

NPI assigned

Aug 2, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Paul RieselmanNPI 1679654974

Title

Owner

Phone

(630) 795-1889

Specialties & licenses 11

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 3

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

• Paul David Rieselman, DC, FNP-BC

  • Family Nurse Practitioner
  • Lisle, IL
  • NPI 1679654974

  Pain Management

  Medicare reassignment Care Compare group NPD Authorized official
• Aleksandr Goldvekht, MD

  • Physical Medicine & Rehabilitation Physician
  • Milwaukee, WI
  • NPI 1700807807

  IL, Pain Medicine

  Medicare reassignment Care Compare group NPD
• Natalie Schultz, MD

  • Reproductive Endocrinology Physician
  • Munster, IN
  • NPI 1558426700

  IL

  Medicare reassignment NPD

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1073869574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4513 LINCOLN AVE",
            "address_2": "#212",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321289",
            "telephone_number": "630-795-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4513 LINCOLN AVE",
            "address_2": "#212",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321289",
            "telephone_number": "630-795-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR INTEGRATED HEALTH & PHYSICAL MEDICINE CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-02",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "RIESELMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-795-1889",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Occupational Health",
            "state": "IL",
            "license": "038010007",
            "primary": false
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": "IL",
            "license": "041384754",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "IL",
            "license": "036110569",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036111510",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "036111510",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IL",
            "license": "036110569",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070019141",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009686",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209009686",
            "primary": false
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "IL",
            "license": "209009686",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Norem, RD
• Robyn Norman, LCPC
• Ellen M Norris, COTA
• Karen Norris, PTA
• Northstar Chiropractic Natural Wellness Center
• Northwest Home Care, Inc.
• Melinda Nowak, PMHNP
• Lauren Ann O'Connor, NP
• Occupational Orthopaedic Surgical Services, LLC
• Eugene D. Oh, M.D.

• Family Nurse Practitioner in Lisle, IL
• Providers in Lisle, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.