Paul M. Baubly, M.D. S. C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

036082085 Issued in IL

Legal business name

PAUL M. BAUBLY, M.D. S. C.

Practice address

103 N Haven Rd FL 2
Elmhurst, IL 60126-2973

Phone

(630) 595-9988

Fax

(331) 225-2296

NPI assigned

Aug 13, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Margaret Hornstra

Title

Office Manager

Phone

(630) 595-9988

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Center Street Medical Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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

• Kathryn Baubly

  • Internal Medicine Physician
  • Elmhurst, IL
  • NPI 1295129310
  Medicare reassignment Care Compare group
• Paul Michael Baubly, MD

  • Internal Medicine Physician
  • Elmhurst, IL
  • NPI 1174681530
  Medicare reassignment Care Compare group
• Jason Alan Castator, M.D.

  • Internal Medicine Physician
  • Bensenville, IL
  • NPI 1972693059
  NPD (past)
• Beverly Ellen Knigge, A.P.N., C.N.P.

  • Primary Care Nurse Practitioner
  • Oak Brook, IL
  • NPI 1871585224
  NPD (past)

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537747200000",
    "number": "1114119245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N HAVEN RD FL 2",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262973",
            "telephone_number": "630-595-9988",
            "fax_number": "313-225-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N HAVEN RD FL 2",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262973",
            "telephone_number": "630-595-9988",
            "fax_number": "331-225-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL M. BAUBLY, M.D. S. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-13",
        "last_updated": "2018-09-24",
        "status": "A",
        "authorized_official_last_name": "HORNSTRA",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "630-595-9988",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036082085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036082085",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center Street Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Center Street Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eric Riley Patten, MD
• Glenn James Patterson, PTA
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• Ilea K Pavel, PT, DPT
• Amy J Pawlik, PT
• Abigail Peachey, PT
• Pediatric Therapy of Illinois LLC

• Primary Care Clinic/Center in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.