NPIMap

Organization Active NPI

Alexian Brothers Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Elk Grove Village, IL
National Provider Identifier
1316169949
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
243397 Issued in NY
Legal business name
ALEXIAN BROTHERS MEDICAL CENTER
Practice address
800 Biesterfield Rd Ste 605
Eberle Medical Office Building
Elk Grove Village, IL 60007-3362
Phone
(718) 644-6778
Fax
(847) 364-6720
NPI assigned
May 3, 2007
Last updated
Jul 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Authorized official

Name
Dr. Ilya Isaakovich Fishman, MD
Title
Physician
Phone
(718) 644-6778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 243397 NY Primary

Addresses

Primary practice location

800 Biesterfield Rd Ste 605
Eberle Medical Office Building
Elk Grove Village, IL 60007-3362

Mailing address

800 Biesterfield Rd Ste 605
Eberle Medical Office Building
Elk Grove Village, IL 60007-3362
Phone (718) 644-6778

National Provider Directory

National Provider Directory
Tax ID family
Alexian Brothers Hospit6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

800 Biesterfield Rd
Ste 605
Elk Grove Vlg, IL 60007
Phone (847) 364-6724

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1316169949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE 605",
            "address_2": "EBERLE MEDICAL OFFICE BUILDING",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073362",
            "telephone_number": "718-644-6778",
            "fax_number": "847-364-6720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE 605",
            "address_2": "EBERLE MEDICAL OFFICE BUILDING",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073362",
            "telephone_number": "718-644-6778",
            "fax_number": "847-364-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXIAN BROTHERS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "FISHMAN",
        "authorized_official_first_name": "ILYA",
        "authorized_official_middle_name": "ISAAKOVICH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "718-644-6778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NY",
            "license": "243397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.