NPIMap

Organization Active NPI

Northwestern Medical Faculty Foundation

Doing business as Northwestern Medical Group/NM Pimary & Specvialty Care

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
National Provider Identifier
1376961524
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
NORTHWESTERN MEDICAL FACULTY FOUNDATION
Doing business as
Northwestern Medical Group/NM Pimary & Specvialty Care
Practice address
259 E Erie St
Suite 2300
Chicago, IL 60611-2987
Phone
(312) 926-6101
Fax
(312) 926-6332
NPI assigned
Apr 4, 2014
Last updated
Jan 23, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHWESTERN MEDICAL FACULTY FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Authorized official

Name
Mr. Russell B. Cox, DIRECTOR
Title
Delegated Official
Phone
(312) 695-7860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

259 E Erie St
Suite 2300
Chicago, IL 60611-2987

Mailing address

680 N Lake Shore Dr
Suite #1000
Chicago, IL 60611-4546
Phone (312) 695-0665

Other names 1

  • Northwestern Medical Group/NM Pimary & Specvialty Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140723000817 IL DME Supplier - Physician - PodiatryDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Orthotic Personnel 4587576814 Practice locations: Chicago, IL

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Northwestern Foundation30 organizations share this tax ID, including this one
Part of
Northwestern Foundation

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1376961524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE #1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-695-0665",
            "fax_number": "312-695-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST",
            "address_2": "SUITE 2300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-926-6101",
            "fax_number": "312-926-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEDICAL FACULTY FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWESTERN MEDICAL FACULTY FOUNDATION",
        "enumeration_date": "2014-04-04",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "312-695-7860",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwestern Medical Group/NM Pimary & Specvialty Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.