Northwest Medical and Urgent Care Center at South Shore LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

NORTHWEST MEDICAL AND URGENT CARE CENTER AT SOUTH SHORE LLC

Practice address

1952 E 73Rd St
Chicago, IL 60649-2902

Phone

(773) 493-5600

NPI assigned

Jul 3, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Tamara Petrov

Title

Office Manager

Phone

(773) 353-5047

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530576000000",
    "number": "1235625138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5352 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252316",
            "telephone_number": "773-353-5047",
            "fax_number": "773-353-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 E 73RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606492902",
            "telephone_number": "773-493-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MEDICAL AND URGENT CARE CENTER AT SOUTH SHORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A",
        "authorized_official_last_name": "PETROV",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "773-353-5047",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest General Surgeons LTD
• Northwest Health Care, LTD
• Northwest Home Care, Inc. (Abcor Home Health, Inc.)
• Northwest Labs LLC
• Northwest Medical and Urgent Care Center at Madison LTD
• Northwest Medical and Urgent Care Center at Yale and 95TH LTD
• Northwest Medical Associates of Chicago LLC
• Northwest Medical Foundation Inc
• Northwest Medical Imaging
• Northwest Orthopaedic Assoc LTD

• Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.