North Shore Physical Medical Group, SC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

036067064 Issued in IL

Legal business name

NORTH SHORE PHYSICAL MEDICAL GROUP, SC

Practice address

1117 S Milwaukee Ave
Suite D-7
Libertyville, IL 60048-3798

Phone

(847) 367-4900

Fax

(847) 367-4904

NPI assigned

Aug 28, 2012

Last updated

Aug 28, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Walter Philip Duzey, DC

Title

Owner/President

Phone

(847) 367-4900

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1225386972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 S MILWAUKEE AVE",
            "address_2": "SUITE D-7",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483798",
            "telephone_number": "847-367-4900",
            "fax_number": "847-367-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 S MILWAUKEE AVE",
            "address_2": "SUITE D-7",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483798",
            "telephone_number": "847-367-4900",
            "fax_number": "847-367-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE PHYSICAL MEDICAL GROUP, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "DUZEY",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "847-367-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036067064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard G Noelte, ATC
• Kelsey Nolan
• Carol Norbeck, D.P.T.
• North Shore Brain and Body Inc
• North Shore Oncology-Hematology Associates, LTD.
• North Shore Primary Care S.C.
• North Shore Pro-Active Health LLC
• North Shore Surgical Associates, S.C.
• North Suburban Family Physicians SC (North Suburban Family Physicians)
• North Suburban Health Care LTD

• Anesthesiology Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.