Organization Active NPI

Vein Clinics of Illinois S.C.

  • Specialist
  • Chicago, IL
National Provider Identifier
1205471877
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
VEIN CLINICS OF ILLINOIS S.C.
Practice address
1212 N la Salle Dr Ste 100
Chicago, IL 60610-2379
Phone
(347) 405-8160
Fax
(347) 405-8161
NPI assigned
Nov 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Authorized official

Name
Caroline Novak, MD
Title
Owner
Phone
(347) 405-8160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1212 N la Salle Dr Ste 100
Chicago, IL 60610-2379

Mailing address

244 Madison Ave # 1120
New York, NY 10016-2817
Phone (347) 405-8160

Other identifiers 1

IdentifierTypeStateIssuer
042.620961OtherILSTATE LICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

1212 N La Salle Dr
Ste 100
Chicago, IL 60610
Phone (312) 241-7897

NPI Registry JSON

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573689600000",
    "number": "1205471877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 MADISON AVE # 1120",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100162817",
            "telephone_number": "347-405-8160",
            "fax_number": "347-405-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N LA SALLE DR STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102379",
            "telephone_number": "347-405-8160",
            "fax_number": "347-405-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN CLINICS OF ILLINOIS S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-14",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-405-8160",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "042.620961",
            "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 Nov 14, 2019; 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.