Sara M Gotheridge MD LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

SARA M GOTHERIDGE MD LLC

Practice address

630 Davis St Ste 301
Evanston, IL 60201-4480

Phone

(312) 640-7731

Fax

(877) 421-1846

NPI assigned

Jun 17, 2020

Last updated

Jun 17, 2020By 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. Sara Margaret Gotheridge, MDNPI 1275630238

Title

President

Phone

(312) 640-7731

Specialties & licenses 1

Addresses

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.

• Sara M Gotheridge, M.D.

  • Psychiatry Physician
  • Chgo, IL
  • NPI 1275630238
  NPD Authorized official

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592352000000",
    "number": "1295351062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 LAWNDALE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011854",
            "telephone_number": "312-608-4996",
            "fax_number": "877-421-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 DAVIS ST STE 301",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014480",
            "telephone_number": "312-640-7731",
            "fax_number": "877-421-1846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 N Michigan Ave Ste 2200",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606017477",
            "country_code": "US",
            "telephone_number": "312-640-7731",
            "fax_number": "877-421-1846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SARA M GOTHERIDGE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A",
        "authorized_official_last_name": "GOTHERIDGE",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "MARGARET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-640-7731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lina Sapiegiene, MD
• Sanjaya Sapkota
• Supriya Sapkota, MD
• Michael Leland Saporito
• Sara K Walz LCSW, LLC
• Sarah H. Levi, Psy.D., P.C.
• Pavlos-Ioannis Saramadis, MD
• Nitu Saran, DO
• Venkatesh Saravanan, MD,MRCP(UK)
• Arona Hankin Sarfatty, L.C.P.C., L.S.W.

• Medical Specialty Clinic/Center in Evanston, IL
• Providers in Evanston, IL by specialty
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.