The Breakers at Edgewater Beach

Primary specialty

Home Infusion AgencyTaxonomy code 251F00000X

License

36381847 Issued in IL

Legal business name

THE BREAKERS AT EDGEWATER BEACH

Practice address

5333 N Sheridan Rd
Chicago, IL 60640-7371

Phone

(773) 878-5333

NPI assigned

May 23, 2011

Last updated

May 23, 2011By 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

Cherie Dupor

Title

Director of Sales and Marketing

Phone

(773) 878-6136

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306108800000",
    "number": "1275826455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407371",
            "telephone_number": "773-878-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407371",
            "telephone_number": "773-878-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BREAKERS AT EDGEWATER BEACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-23",
        "last_updated": "2011-05-23",
        "status": "A",
        "authorized_official_last_name": "DUPOR",
        "authorized_official_first_name": "CHERIE",
        "authorized_official_title_or_position": "DIRECTOR OF SALES AND MARKETING",
        "authorized_official_telephone_number": "773-878-6136"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "IL",
            "license": "36381847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Infusion Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Home Infusion Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2011; 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.