North Shore Physicians Group, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NORTH SHORE PHYSICIANS GROUP, LLC

Practice address

525 Winnetka Ave
Winnetka, IL 60093-4050

Phone

(847) 501-4060

NPI assigned

May 18, 2006

Last updated

Jul 11, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John E Croghan, MD

Title

Authorized Representative

Phone

(847) 251-1500

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Roman W Mandzij, DO

  • Internal Medicine Physician
  • Winnetka, IL
  • NPI 1841239902
  NPD (past)
• Thomas A Stern, MD

  • Internal Medicine Physician
  • Winnetka, IL
  • NPI 1477592665
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1093768228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 WINNETKA AVE",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600934050",
            "telephone_number": "847-501-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 WINNETKA AVE",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600934050",
            "telephone_number": "847-501-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE PHYSICIANS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "CROGHAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "847-251-1500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myeyedr Optometry of Illinois, LLC (MyEyeDr.)
• Susan J Nelson, MD
• Kate Newman
• William Louis Nickel, DDS
• North Groves Internal Medicine SC
• Eduard Obolsky, M.D.
• Robin Ann Ogden, RPH
• Dimple Patel, MPT
• Patrick Brady DMD Ms PC (Brady Orthodontics)
• Patrick W. Logan, MD

• Internal Medicine Physician in Winnetka, IL
• Providers in Winnetka, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.