Edge Medical Center LTD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

EDGE MEDICAL CENTER LTD

Practice address

2357 Hassell Rd
Suite 204
Hoffman Estates, IL 60169-2172

Phone

(847) 839-8888

Fax

(847) 839-9660

NPI assigned

May 11, 2017

Organization subpart

No

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

Authorized official

Name

Cameron Clark

Title

Administrator

Phone

(847) 839-8888

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500595200000",
    "number": "1407383292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2357 HASSELL RD",
            "address_2": "SUITE 204",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601692172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2357 HASSELL RD",
            "address_2": "SUITE 204",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601692172",
            "telephone_number": "847-839-8888",
            "fax_number": "847-839-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE MEDICAL CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-07-21",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-839-8888"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Lynn Dybala, PA-C
• E-Ztherapy,LLC
• Gregory Eakle, LPN
• Christopher Early
• Eastern Rise, LLC.
• Jessica Katz Edison, M.D.
• Emily Edlynn, PH.D.
• Kirsten M Edwards, LCSW
• Edwin P. Soriano, M.D., S.C.
• Kaitlyn Eichinger-Murphy, PSYD

• General Practice Physician in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2017; 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.