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Organization Active NPI

Infectious Disease Specialists of Chicago

  • Infectious Disease Physician
  • Chicago, IL
National Provider Identifier
1194786574
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
INFECTIOUS DISEASE SPECIALISTS OF CHICAGO
Practice address
600 S Paulina St
Suite 143
Chicago, IL 60612-3806
Phone
(312) 942-2061
Fax
(312) 942-2184
NPI assigned
Mar 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Authorized official

Name
Dr. Gordon M Trenholme, M.D.
Title
President
Phone
(312) 942-2061

Specialties & licenses 1

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

Addresses

Primary practice location

600 S Paulina St
Suite 143
Chicago, IL 60612-3806

Mailing address

PO Box 239D
Park Ridge, IL 60068-8018
Phone (847) 732-8087

Other identifiers 2

IdentifierTypeStateIssuer
21623155OtherILBLUE SHIELD GROUP #
CJ6213OtherILRR MEDICARE GROUP #

National Provider Directory

National Provider Directory

Locations

600 S Paulina St
Ste 143
Chicago, IL 60612
Phone (312) 942-2061

Practitioners & affiliated clinicians

Practitioners 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1194786574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 239D",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688018",
            "telephone_number": "847-732-8087",
            "fax_number": "708-395-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST",
            "address_2": "SUITE 143",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806",
            "telephone_number": "312-942-2061",
            "fax_number": "312-942-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASE SPECIALISTS OF CHICAGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "TRENHOLME",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-942-2061",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP #",
            "identifier": "21623155",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP #",
            "identifier": "CJ6213",
            "state": "IL"
        }
    ],
    "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 Dec 3, 2007; 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.