Organization Active NPI

Cary J Bortnick MD LTD

  • Internal Medicine Physician
  • Bloomingdale, IL
National Provider Identifier
1124113980
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CARY J BORTNICK MD LTD
Practice address
303 E Army Trail Rd
Suite 100
Bloomingdale, IL 60108
Phone
(630) 980-8600
Fax
(630) 980-8650
NPI assigned
Oct 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Sulema Jimenez
Title
Office Manager
Phone
(630) 980-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

303 E Army Trail Rd
Suite 100
Bloomingdale, IL 60108

Mailing address

303 E Army Trail Rd
Suite 100
Bloomingdale, IL 60108
Phone (630) 980-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050512000178 IL Part B Supplier - Clinic/Group Practice 7113967886 Receives reassigned benefits from 3 practitioners
Practice locations: Bloomingdale, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124113980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E ARMY TRAIL RD",
            "address_2": "SUITE 100",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "60108",
            "telephone_number": "630-980-8600",
            "fax_number": "630-980-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E ARMY TRAIL RD",
            "address_2": "SUITE 100",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "60108",
            "telephone_number": "630-980-8600",
            "fax_number": "630-980-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARY J BORTNICK MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "SULEMA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "630-980-8600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.