Neuromed Clinic LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

036111136 Issued in IL

Legal business name

NEUROMED CLINIC LLC

Practice address

3S517 Winfield Rd
Ste a
Warrenville, IL 60555-3159

Phone

(630) 836-9121

NPI assigned

Jun 18, 2006

Last updated

Sep 15, 2009By 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

Mary L Banks

Title

Director Patient Services

Phone

(630) 836-9121

Specialties & licenses 10

Addresses

Other identifiers 10

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.

• Konstantin Dzamashvili, MD

  • Neurology Physician
  • Fort Myers, FL
  • NPI 1174529085
  NPD (past)

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

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    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252972800000",
    "number": "1316982846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3S517 WINFIELD RD",
            "address_2": "STE A",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553159",
            "telephone_number": "630-836-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3S517 WINFIELD RD",
            "address_2": "STE A",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553159",
            "telephone_number": "630-836-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROMED CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2009-09-15",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR PATIENT SERVICES",
        "authorized_official_telephone_number": "630-836-9121"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
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        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
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        },
        {
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        {
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        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "IL",
            "license": "036121731",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
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        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036107234",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "IL",
            "license": "036075202",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "IL",
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        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
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            "state": "IL"
        },
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            "code": "05",
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            "identifier": "1316982846",
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        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "220232500",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2232580",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209006135",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP RAILROAD MEDICARE",
            "identifier": "CD3784",
            "state": "IL"
        },
        {
            "code": "05",
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            "issuer": null,
            "identifier": "036075202",
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        },
        {
            "code": "05",
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            "issuer": null,
            "identifier": "036107234",
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        },
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    ],
    "endpoints": [],
    "other_names": []
}

• Anna Navigato, PA-C
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• Neurosurgery Spine & Pain Assoc PC (Midwest Neurosurgery & Spine Specialists PC)
• New Hope Clinical Services, LLC
• New Reflection Clinical Services
• Sara Y Niederbrach
• Nimble Corporation

• Neurology Physician in Warrenville, IL
• Providers in Warrenville, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.