NPIMap

Organization Active NPI

Medpro Vascular Institute

  • Vascular Surgery Physician
  • South Elgin, IL
National Provider Identifier
1235598566
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
036117153 Issued in IL
Legal business name
MEDPRO VASCULAR INSTITUTE
Practice address
472 Briargate Dr
Unit 107
South Elgin, IL 60177-2225
Phone
(224) 535-8758
NPI assigned
Feb 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Authorized official

Name
Mrs. Robin HoffmanNPI 1982935482
Title
Ceo/Member
Phone
(224) 535-8758

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X 036117153 IL Primary

Addresses

Primary practice location

472 Briargate Dr
Unit 107
South Elgin, IL 60177-2225

Mailing address

472 Briargate Dr
Unit 107
South Elgin, IL 60177-2225

National Provider Directory

National Provider Directory

Locations

472 Briargate Dr
Unit 107
South Elgin, IL 60177
Phone (224) 535-8758

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1235598566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 BRIARGATE DR",
            "address_2": "UNIT 107",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601772225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 BRIARGATE DR",
            "address_2": "UNIT 107",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601772225",
            "telephone_number": "224-535-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDPRO VASCULAR INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "CEO/MEMBER",
        "authorized_official_telephone_number": "224-535-8758",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036117153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.