Organization Active NPI

North Suburban Gastroenterology

  • Gastroenterology Physician
  • Park Ridge, IL
National Provider Identifier
1114037041
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
NORTH SUBURBAN GASTROENTEROLOGY
Practice address
711 W Devon
Park Ridge, IL 60068-4713
Phone
(847) 696-3176
Fax
(847) 696-2678
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Authorized official

Name
Dr. Anthony A Grande, M.D.
Title
President
Phone
(847) 696-3176

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

711 W Devon
Park Ridge, IL 60068-4713

Mailing address

711 W Devon
Park Ridge, IL 60068-4713
Phone (847) 696-3176

National Provider Directory

National Provider Directory

Locations

7447 W Talcott Ave
Ste 358
Chicago, IL 60631
Phone (773) 774-7227

950 N Northwest Hwy
Park Ridge, IL 60068
Phone (847) 696-3176

Practitioners & affiliated clinicians

Practitioners 1

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1114037041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W DEVON",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684713",
            "telephone_number": "847-696-3176",
            "fax_number": "847-696-2678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W DEVON",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684713",
            "telephone_number": "847-696-3176",
            "fax_number": "847-696-2678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUBURBAN GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "GRANDE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-696-3176",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.