Skokie Family Clinic P.C.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

036119286 Issued in IL

Legal business name

SKOKIE FAMILY CLINIC P.C.

Practice address

4726 Oakton St
Skokie, IL 60076-3000

Phone

(847) 674-0455

Fax

(847) 674-0466

NPI assigned

Sep 14, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Dima Hanna, MDNPI 1710041892

Title

Physician

Phone

(847) 778-6572

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 5

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

• Dima R Hanna, M.D.

  • Family Medicine Physician
  • Morton Grove, IL
  • NPI 1710041892
  Medicare reassignment NPD Authorized official
• Louis Basaka, DNP, FNP-C

  • Family Nurse Practitioner
  • Skokie, IL
  • NPI 1912731316
  Medicare reassignment NPD
• Stephanie Guliana

  • Family Nurse Practitioner
  • Skokie, IL
  • NPI 1841165362
  Medicare reassignment NPD
• Jacob John, PA

  • Physician Assistant
  • Skokie, IL
  • NPI 1417427543
  Medicare reassignment
• Jenna Spaeth, PA-C

  • Medical Physician Assistant
  • Long Grove, IL
  • NPI 1669857512
  Medicare reassignment

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1114250875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4726 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763000",
            "telephone_number": "847-674-0455",
            "fax_number": "847-674-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4726 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763000",
            "telephone_number": "847-674-0455",
            "fax_number": "847-674-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKOKIE FAMILY CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-14",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "DIMA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "847-778-6572",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "036119286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skokie Dental Professionals LLC
• Skokie Elementary Dist 68
• Skokie Elementary Dist 69
• Skokie Emergency Services, LLC
• Skokie Fairview Elem Dist 72
• Skokie Family Dentistry PLLC
• Skokie Foot & Ankle Specialists, LTD.
• Skokie Home and Nursing Services
• Skokie Meadow Nursing Center Inc
• Skokie Meadows LLC

• Clinic/Center in Skokie, IL
• Providers in Skokie, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.