Neuro-Diagnostic Institute LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

036066313 Issued in IL

Legal business name

NEURO-DIAGNOSTIC INSTITUTE LLC

Practice address

1201 Hohlfelder Rd
100
Glencoe, IL 60022-1020

Phone

(847) 471-8587

NPI assigned

Dec 17, 2010

Last updated

Feb 22, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Simon Zimnowodzki, MD

Title

President

Phone

(847) 471-8587

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298332800000",
    "number": "1154624823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 HOHLFELDER RD",
            "address_2": "100",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221020",
            "telephone_number": "847-471-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HOHLFELDER RD",
            "address_2": "100",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221020",
            "telephone_number": "847-471-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO-DIAGNOSTIC INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-17",
        "last_updated": "2011-02-22",
        "status": "A",
        "authorized_official_last_name": "ZIMNOWODZKI",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-471-8587",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036066313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Glencoe, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.