Northshore Medical Center, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTHSHORE MEDICAL CENTER, LLC

Practice address

1300 Busch Pkwy
Buffalo Grove, IL 60089-4505

Phone

(847) 850-5882

Fax

(847) 850-5892

NPI assigned

Jul 31, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Victoria Plebanovich

Title

Managing Director

Phone

(847) 279-7963

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296086400000",
    "number": "1306036819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BUSCH PKWY",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894505",
            "telephone_number": "847-850-5882",
            "fax_number": "847-850-5892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BUSCH PKWY",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894505",
            "telephone_number": "847-850-5882",
            "fax_number": "847-850-5892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2011-01-27",
        "status": "A",
        "authorized_official_last_name": "PLEBANOVICH",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "847-279-7963",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Buffalo Grove, IL
• Providers in Buffalo Grove, 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 Jan 27, 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.