Susan C Balberde, MD,SC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

036046845 Issued in IL

Legal business name

SUSAN C BALBERDE, MD,SC

Practice address

8330 Grand Ave
River Grove, IL 60171-1435

Phone

(708) 681-3000

NPI assigned

Nov 12, 2013

Last updated

Nov 12, 2013By 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. Susan Balverde, M.D.

Title

President

Phone

(773) 525-4511

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384214400000",
    "number": "1295165256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5524 N PIONEER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606561546",
            "telephone_number": "773-525-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8330 GRAND AVE",
            "city": "RIVER GROVE",
            "state": "IL",
            "postal_code": "601711435",
            "telephone_number": "708-681-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN C BALBERDE, MD,SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-12",
        "last_updated": "2013-11-12",
        "status": "A",
        "authorized_official_last_name": "BALVERDE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-525-4511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036046845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Leonard Siwek, D.D.S
• Angela Maria Snyder, MSN, FNP-BC
• Charles R Soderquist, DDS
• James J Stawowy, PHARMACIST
• Danuta B Superson, LMT
• Thtacher Woods Associates LTD
• Village of River Grove
• Vision Man
• Walgreen Co (Walgreens #00829)
• Walgreen Co. (Walgreens #829)

• Primary Care Clinic/Center in River Grove, IL
• Providers in River Grove, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.