Medical Care of North Chicago, LTD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036105632 Issued in IL

Legal business name

MEDICAL CARE OF NORTH CHICAGO, LTD

Practice address

2222 W Division St
Suite 200
Chicago, IL 60622-2717

Phone

(773) 744-7712

Fax

(773) 395-8400

NPI assigned

Feb 23, 2007

Last updated

Feb 10, 2015By 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

Mrs. Lubov A Klemine, M.D.NPI 1124228853

Title

President

Phone

(773) 744-7712

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

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.

• Lubov A Klemine, M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1124228853

  Single Specialty

  Medicare reassignment NPD Authorized official
• Mila C R Bacalla, MD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1942288550
  NPD (past)
• Mrugendra M. Gandhi, M.D.

  • Surgery Physician
  • Fox Lake, IL
  • NPI 1528050978
  NPD (past)

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1285760546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600255004",
            "telephone_number": "773-744-7712",
            "fax_number": "773-395-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W DIVISION ST",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222717",
            "telephone_number": "773-744-7712",
            "fax_number": "773-395-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CARE OF NORTH CHICAGO, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "KLEMINE",
        "authorized_official_first_name": "LUBOV",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-744-7712",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036105632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105632",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.