Marine Drive Medical Group, LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MARINE DRIVE MEDICAL GROUP, LTD

Practice address

4646 N Marine Dr
#C6300
Chicago, IL 60640-5759

Phone

(773) 728-7373

Fax

(773) 728-3538

NPI assigned

Jul 7, 2006

Last updated

Aug 22, 2020By 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. James T McCreary, MD

Title

Ceo/President

Phone

(773) 728-7373

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235162058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR",
            "address_2": "#C6300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759",
            "telephone_number": "773-728-7373",
            "fax_number": "773-728-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR",
            "address_2": "#C6300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759",
            "telephone_number": "773-728-7373",
            "fax_number": "773-728-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINE DRIVE MEDICAL GROUP, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCREARY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "773-728-7373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "01615083",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Marin, MD
• Sean Alden Marin
• Stephanie Marin
• Marina Kuznetsova MD SC
• Marine Anesthesia LLC
• Alejandra M Marinelarena, MD PHD
• Melissa Ann Marinelli, M.D.
• Richard F Marinello, DDS
• Alba Mariner Gonzalez
• Karolina Katarzyna Marinescu, MD

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.