NPIMap

Organization Active NPI

Medi Doc Inc

  • Family Medicine Physician
  • Skokie, IL
National Provider Identifier
1184895310
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036042276 Issued in IL
Legal business name
MEDI DOC INC
Practice address
5200 Suffield CT
Skokie, IL 60077-1527
Phone
(847) 583-8427
NPI assigned
Mar 15, 2008
Last updated
May 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Dr. Howard Rubin, MD
Title
President
Phone
(847) 583-8427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 036042276 IL Primary

Addresses

Primary practice location

5200 Suffield CT
Skokie, IL 60077-1527

Mailing address

5200 Suffield CT
Skokie, IL 60077-1527
Phone (847) 583-8427

Other identifiers 1

IdentifierTypeStateIssuer
1621999OtherILBCBS OF IL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1205539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1184895310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 SUFFIELD CT",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771527",
            "telephone_number": "847-583-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 SUFFIELD CT",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771527",
            "telephone_number": "847-583-8427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI DOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-15",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-583-8427",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036042276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "1621999",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.