Excelsior Medical Center LTD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

EXCELSIOR MEDICAL CENTER LTD

Practice address

333 E Il Route 83
Suite 107
Mundelein, IL 60060-4214

Phone

(847) 566-5556

Fax

(847) 566-8886

NPI assigned

Jan 19, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Olga Ulyanova, M.D.

Title

Owner

Phone

(847) 566-5556

Specialties & licenses 1

Addresses

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 1

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

• Vladimir Ulyanov, M.D.

  • Pediatrics Physician
  • Mundelein, IL
  • NPI 1932389863
  NPD (past)

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

{
    "created_epoch": "1200700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200700800000",
    "number": "1174709117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E IL ROUTE 83",
            "address_2": "SUITE 107",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600604214",
            "telephone_number": "847-566-5556",
            "fax_number": "847-566-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E IL ROUTE 83",
            "address_2": "SUITE 107",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600604214",
            "telephone_number": "847-566-5556",
            "fax_number": "847-566-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIOR MEDICAL CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-19",
        "last_updated": "2008-01-19",
        "status": "A",
        "authorized_official_last_name": "ULYANOVA",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-566-5556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Joseph Escobar, ANP
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• Family Chiropractor, Inc
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• Bright Fellowes, PSYD
• Barbara First, MD

• Pediatrics Physician in Mundelein, IL
• Providers in Mundelein, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.