NPIMap

Organization Active NPI

Fifth Ave Primary Care Physicians SC

  • Family Medicine Physician
  • St Charles, IL
National Provider Identifier
1215029467
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042-003468 Issued in IL
Legal business name
FIFTH AVE PRIMARY CARE PHYSICIANS SC
Practice address
2570 Foxfield Rd
Suite 100
St Charles, IL 60174-1406
Phone
(630) 584-1950
Fax
(630) 584-8994
NPI assigned
Sep 28, 2006
Last updated
Sep 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Authorized official

Name
Dr. Catherine S Thomas, M.D.NPI 1295785756
Title
Owner
Phone
(630) 584-1950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 042-003468 IL Primary

Addresses

Primary practice location

2570 Foxfield Rd
Suite 100
St Charles, IL 60174-1406

Mailing address

2570 Foxfield Rd
Suite 100
St Charles, IL 60174-1406
Phone (630) 584-1950

National Provider Directory

National Provider Directory

Locations

970 N 5th Ave
St Charles, IL 60174
Phone (630) 584-1950

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1215029467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 FOXFIELD RD",
            "address_2": "SUITE 100",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741406",
            "telephone_number": "630-584-1950",
            "fax_number": "630-584-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 FOXFIELD RD",
            "address_2": "SUITE 100",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741406",
            "telephone_number": "630-584-1950",
            "fax_number": "630-584-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIFTH AVE PRIMARY CARE PHYSICIANS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-584-1950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "042-003468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.