Dr Russell Kubycheck SC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036-056399 Issued in IL

Legal business name

DR RUSSELL KUBYCHECK SC

Practice address

333 Chestnut Street
#207
Hinsdale, IL 60521

Phone

(630) 789-0400

Fax

(630) 789-1504

NPI assigned

Dec 3, 2010

Organization subpart

No

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

Authorized official

Name

Russell M Kubycheck, M.D.

Title

Owner/Doctor

Phone

(630) 789-0400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1134421639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CHESTNUT STREET",
            "address_2": "#207",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "60521",
            "telephone_number": "630-789-0400",
            "fax_number": "630-789-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CHESTNUT STREET",
            "address_2": "#207",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "60521",
            "telephone_number": "630-789-0400",
            "fax_number": "630-789-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RUSSELL KUBYCHECK SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "KUBYCHECK",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "630-789-0400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-056399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036056399",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.