Organization Active NPI

Boston Medical Group, P.C.

  • Urology Physician
  • Chicago, IL
National Provider Identifier
1174940480
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
BOSTON MEDICAL GROUP, P.C.
Practice address
30 N Michigan Ave
Suite 706
Chicago, IL 60602
Phone
(312) 443-1373
Fax
(312) 443-1461
NPI assigned
Mar 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Authorized official

Name
Ms. Marianne C Labarbera, M.D.
Title
Medical Director
Phone
(718) 981-4070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

30 N Michigan Ave
Suite 706
Chicago, IL 60602

Mailing address

30 N Michigan Ave
Suite 706
Chicago, IL 60602
Phone (312) 443-1373

National Provider Directory

National Provider Directory

Locations

30 N Michigan Ave
Ste 706
Chicago, IL 60602
Phone (312) 443-1373

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395705600000",
    "number": "1174940480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 706",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60602",
            "telephone_number": "312-443-1373",
            "fax_number": "312-443-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 706",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60602",
            "telephone_number": "312-443-1373",
            "fax_number": "312-443-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-25",
        "last_updated": "2014-03-25",
        "status": "A",
        "authorized_official_last_name": "LABARBERA",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-981-4070",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; 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.