NPIMap

Organization Active NPI

Medspa Women Health Center

  • Specialist
  • Bloomingdale, IL
National Provider Identifier
1285937292
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036.118893 Issued in IL
Legal business name
MEDSPA WOMEN HEALTH CENTER
Practice address
1 Tiffany PT
Suite G1
Bloomingdale, IL 60108-2936
Phone
(847) 466-5905
Fax
(847) 466-5912
NPI assigned
Dec 13, 2010
Last updated
Dec 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Authorized official

Name
Samuel F Botros, MDNPI 1568637866
Title
MD
Phone
(847) 466-5905

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036.118893 IL Primary

Addresses

Primary practice location

1 Tiffany PT
Suite G1
Bloomingdale, IL 60108-2936

Mailing address

1 Tiffany PT
Suite G1
Bloomingdale, IL 60108-2936
Phone (847) 466-5905

National Provider Directory

National Provider Directory

Locations

1 Tiffany Pt
Ste G1
Bloomingdale, IL 60108
Phone (847) 466-5905

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1285937292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TIFFANY PT",
            "address_2": "SUITE G1",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082936",
            "telephone_number": "847-466-5905",
            "fax_number": "847-466-5912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TIFFANY PT",
            "address_2": "SUITE G1",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082936",
            "telephone_number": "847-466-5905",
            "fax_number": "847-466-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSPA WOMEN HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "BOTROS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "847-466-5905",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036.118893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.