NPIMap

Organization Active NPI

Anton Dubrick MD SC

  • General Practice Physician
  • Salem, IL
National Provider Identifier
1316456965
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036061031 Issued in IL
Legal business name
ANTON DUBRICK MD SC
Practice address
420 W Schwartz St
Salem, IL 62881-1552
Phone
(618) 740-4667
Fax
(618) 740-1482
NPI assigned
Sep 27, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Anton Dubrick, MDNPI 1568485043
Title
President
Phone
(618) 740-4667

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
General Practice Physician 208D00000X 036061031 IL Primary

Addresses

Primary practice location

420 W Schwartz St
Salem, IL 62881-1552

Mailing address

420 W Schwartz St
Salem, IL 62881-1552
Phone (618) 740-4667

National Provider Directory

National Provider Directory

Locations

420 W Schwartz St
Salem, IL 62881
Phone (618) 740-4667

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": "1506470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1316456965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W SCHWARTZ ST",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628811552",
            "telephone_number": "618-740-4667",
            "fax_number": "618-740-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W SCHWARTZ ST",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628811552",
            "telephone_number": "618-740-4667",
            "fax_number": "618-740-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTON DUBRICK MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DUBRICK",
        "authorized_official_first_name": "ANTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-740-4667",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036061031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.