NPIMap

Organization Active NPI

Northwestern Memorial Physicians Group

Doing business as NMPG (Secondary)

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1255699062
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTHWESTERN MEMORIAL PHYSICIANS GROUP
Doing business as
NMPG (Secondary)
Practice address
680 N Lake Shore Dr
Suite 818
Chicago, IL 60611-4546
Phone
(312) 926-6146
NPI assigned
Apr 30, 2012
Last updated
Apr 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Authorized official

Name
Jeff Kopin, MD
Title
Vice President
Phone
(312) 926-6146

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU
Registered Dietitian 133V00000X NU
Dermatology Physician 207N00000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU
Pediatrics Physician 208000000X NU
Surgery Physician 208600000X NU

Addresses

Primary practice location

680 N Lake Shore Dr
Suite 818
Chicago, IL 60611-4546

Mailing address

680 N Lake Shore Dr
Suite 818
Chicago, IL 60611-4546

Other names 1

  • NMPG (Secondary) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
NMPG Secondary2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1255699062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 818",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 818",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-926-6146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEMORIAL PHYSICIANS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "KOPIN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "312-926-6146",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NMPG (Secondary)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.