Organization Active NPI

Briarwood Medical Center

  • Pediatric Adolescent Medicine Physician
  • South Elgin, IL
National Provider Identifier
1376632182
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
BRIARWOOD MEDICAL CENTER
Practice address
472 Briargate Drive
South Elgin, IL 60177
Phone
(847) 717-6400
Fax
(847) 717-0500
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Authorized official

Name
Mr. Cameron Safarloo
Title
Ceo
Phone
(630) 907-6009

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X IL
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X IL Primary

Addresses

Primary practice location

472 Briargate Drive
South Elgin, IL 60177

Mailing address

472 Briargate Drive
South Elgin, IL 60177-2225
Phone (847) 717-6400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188259200000",
    "number": "1376632182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 BRIARGATE DRIVE",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601772225",
            "telephone_number": "847-717-6400",
            "fax_number": "847-717-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 BRIARGATE DRIVE",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "60177",
            "telephone_number": "847-717-6400",
            "fax_number": "847-717-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIARWOOD MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-08-28",
        "status": "A",
        "authorized_official_last_name": "SAFARLOO",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "630-907-6009",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.