NPIMap

Organization Active NPI

Northwest Infectious Disease Consultants, S.C.

  • Infectious Disease Physician
  • Niles, IL
National Provider Identifier
1194775221
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
042617264 Issued in IL
Legal business name
NORTHWEST INFECTIOUS DISEASE CONSULTANTS, S.C.
Practice address
7900 N Milwaukee Ave
Suite 231
Niles, IL 60714-3159
Phone
(847) 663-9400
NPI assigned
May 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Authorized official

Name
Robert J. Citronberg, M.D.
Title
President
Phone
(847) 663-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X 042617264 IL Primary

Addresses

Primary practice location

7900 N Milwaukee Ave
Suite 231
Niles, IL 60714-3159

Mailing address

7900 N Milwaukee Ave
Suite 231
Niles, IL 60714-3159
Phone (847) 663-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323001105 IL Part B Supplier - Clinic/Group Practice 5395636914 Receives reassigned benefits from 10 practitioners
Practice locations: Niles, IL

National Provider Directory

National Provider Directory

Locations

36490 Treasury Ctr
Chicago, IL 60694

7900 N Milwaukee Ave
#231
Niles, IL 60714
Phone (847) 663-9400

7900 N Milwaukee Ave
Ste 231A
Niles, IL 60714
Phone (847) 663-9400

7900 N Milwaukee Ave
Ste 231
Niles, IL 60714
Phone (847) 663-9400

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291766400000",
    "number": "1194775221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE",
            "address_2": "SUITE 231",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143159",
            "telephone_number": "847-663-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE",
            "address_2": "SUITE 231",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143159",
            "telephone_number": "847-663-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST INFECTIOUS DISEASE CONSULTANTS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-12-08",
        "status": "A",
        "authorized_official_last_name": "CITRONBERG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-663-9400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "042617264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.