NPIMap

Organization Active NPI

Northwest Primary Care PC

  • Internal Medicine Physician
  • Algonquin, IL
National Provider Identifier
1225344906
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTHWEST PRIMARY CARE PC
Practice address
2214 Huntington Dr N
Algonquin, IL 60102-4419
Phone
(847) 458-4500
Fax
(847) 458-4503
NPI assigned
Aug 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Authorized official

Name
Dr. Devang N Dharia, M.D.
Title
M.D.
Phone
(847) 458-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2214 Huntington Dr N
Algonquin, IL 60102-4419

Mailing address

2214 Huntington Dr N
Algonquin, IL 60102-4419
Phone (847) 458-4500

Other identifiers 6

IdentifierTypeStateIssuer
IL6276OtherPTAN
IL6276OtherILPTAN
IL6278OtherPTAN
IL6277OtherILPTAN
IL6277OtherPTAN
IL6278OtherILPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111209000419 IL Part B Supplier - Clinic/Group Practice 6608041207 Receives reassigned benefits from 17 practitioners
Practice locations: Algonquin, IL

National Provider Directory

National Provider Directory

Locations

2214 Huntington Dr N
Algonquin, IL 60102
Phone (224) 348-7981

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1225344906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 HUNTINGTON DR N",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601024419",
            "telephone_number": "847-458-4500",
            "fax_number": "847-458-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 HUNTINGTON DR N",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601024419",
            "telephone_number": "847-458-4500",
            "fax_number": "847-458-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-19",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "DHARIA",
        "authorized_official_first_name": "DEVANG",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "847-458-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IL6276",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IL6276",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IL6278",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IL6277",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IL6277",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IL6278",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Algonquin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.