NPIMap

Organization Active NPI

Nephrology Specialists SC

  • Nephrology Physician
  • Libertyville, IL
National Provider Identifier
1083933006
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036100394 Issued in IL
Legal business name
NEPHROLOGY SPECIALISTS SC
Practice address
1272 American Way
Libertyville, IL 60048-3936
Phone
(847) 549-7222
NPI assigned
Jun 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Authorized official

Name
Joshua Robert Trob, MDNPI 1548217144
Title
MD
Phone
(847) 549-7222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 036100394 IL Primary

Addresses

Primary practice location

1272 American Way
Libertyville, IL 60048-3936

Mailing address

PO Box 967
Tinley Park, IL 60477-0967

National Provider Directory

National Provider Directory

Locations

1272 American Way
Libertyville, IL 60048
Phone (847) 549-1632

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337299200000",
    "number": "1083933006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604770967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 AMERICAN WAY",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483936",
            "telephone_number": "847-549-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY SPECIALISTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-01",
        "last_updated": "2012-05-18",
        "status": "A",
        "authorized_official_last_name": "TROB",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "847-549-7222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036100394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; 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.