Myron Bornstein MD SC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036-038938 Issued in IL

Legal business name

MYRON BORNSTEIN MD SC

Practice address

425 Davis St Unit 519
Evanston, IL 60201-4790

Phone

(847) 433-2290

NPI assigned

Jan 2, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Myron Bornstein, M.D.NPI 1255461463

Title

President

Phone

(847) 433-7001

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MYRON BORNSTEIN MD SC Former legal business name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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.

• Myron Philip Bornstein, M.D.

  • Psychiatry Physician
  • Evanston, IL
  • NPI 1255461463
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604016000000",
    "number": "1326223934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 1ST ST",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353200",
            "telephone_number": "847-433-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 DAVIS ST UNIT 519",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014790",
            "telephone_number": "847-433-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRON BORNSTEIN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A",
        "authorized_official_last_name": "BORNSTEIN",
        "authorized_official_first_name": "MYRON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-433-7001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-038938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SC ID",
            "identifier": "208695",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MYRON BORNSTEIN MD SC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• MVMT Evanston Physical Therapy PLLC
• Peter G Myers, PSY.D.
• Myeyedr Optometry of Illinois, LLC (MyEyeDr.)
• Myeyedr Optometry of Illinois, LLC (MyEyeDr.)
• Grace Myhre, PHARMD
• Carolyn Myszkowski, LCPC
• Yosra Nadhimi
• Laxmi Venkata Manisha Reddy Naganatanahalli
• Priya Nagarajan, DO
• Michael A Nagelbach, PYS.D.

• Psychiatry Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.