Illinois Medical Doctors of Naperville Enterprising SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ILLINOIS MEDICAL DOCTORS OF NAPERVILLE ENTERPRISING SC

Practice address

1891 Bay Scott Cir
Ste 109
Naperville, IL 60540-1137

Phone

(630) 527-6400

Fax

(630) 527-6411

NPI assigned

May 28, 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. Matthew S Carducci, M.D.

Title

Owner

Phone

(630) 527-6400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255388807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 BAY SCOTT CIR",
            "address_2": "STE 109",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605401137",
            "telephone_number": "630-527-6400",
            "fax_number": "630-527-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 BAY SCOTT CIR",
            "address_2": "STE 109",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605401137",
            "telephone_number": "630-527-6400",
            "fax_number": "630-527-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS MEDICAL DOCTORS OF NAPERVILLE ENTERPRISING SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARDUCCI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-527-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.