NPIMap

Organization Active NPI

Geriatric Care Specialists,LTD

  • Geriatric Medicine (Family Medicine) Physician
  • Western Springs, IL
National Provider Identifier
1336260488
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
036075925 Issued in IL
Legal business name
GERIATRIC CARE SPECIALISTS,LTD
Practice address
512 Hillgrove Ave
Western Springs, IL 60558-1442
Phone
(630) 440-4281
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Dr. Jerome Vincent Donnelly, DO
Title
Physician
Phone
(630) 440-4281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X 036075925 IL Primary

Addresses

Primary practice location

512 Hillgrove Ave
Western Springs, IL 60558-1442

Mailing address

PO Box 900
La Grange, IL 60525-0900
Phone (630) 440-4281

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1336260488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 900",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605250900",
            "telephone_number": "630-440-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 HILLGROVE AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581442",
            "telephone_number": "630-440-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC CARE SPECIALISTS,LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "DONNELLY",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "630-440-4281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036075925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Western Springs, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.