Golden Corridor Family Young Men's Christian Association

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

GOLDEN CORRIDOR FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

Practice address

300 W Wise Road
Schaumburg, IL 60193

Phone

(847) 891-9622

Fax

(847) 891-8901

NPI assigned

Jan 12, 2018

Last updated

Jan 12, 2018By 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

David R Burisek

Title

Coo

Phone

(224) 760-7022

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515715200000",
    "number": "1225546203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W WISE ROAD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "60193",
            "telephone_number": "847-891-9622",
            "fax_number": "847-891-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W WISE ROAD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "60193",
            "telephone_number": "847-891-9622",
            "fax_number": "847-891-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN CORRIDOR FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-01-12",
        "status": "A",
        "authorized_official_last_name": "BURISEK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "224-760-7022"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vijay Kumar Godi, DDS
• Bodie K Godwin, O.D.
• Sarah Goedjen, MA
• Keri Gold
• Abigail C Goldberg, MA
• Omar Gomez
• Susan Terese Gomez, P.A.-C
• Margaret Gong, DMD
• Amy Gonzalez, APN
• Ashley Maxie Gonzalez, LMT

• Health Educator in Schaumburg, IL
• Providers in Schaumburg, IL by specialty
• Health Educator in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2018; 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.