Organization Active NPI

Doctors of the North Shore SC

  • Family Medicine Physician
  • Morton Grove, IL
National Provider Identifier
1407821572
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DOCTORS OF THE NORTH SHORE SC
Practice address
6131 W Dempster
Morton Grove, IL 60053
Phone
(847) 967-5010
Fax
(847) 967-5147
NPI assigned
Feb 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Authorized official

Name
Jennifer Pfeifer
Title
Practice Manager
Phone
(847) 967-5010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6131 W Dempster
Morton Grove, IL 60053

Mailing address

6131 W Dempster
Morton Grove, IL 60053
Phone (847) 967-5010

Other identifiers 1

IdentifierTypeStateIssuer
01632926OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1407821572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6131 W DEMPSTER",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "60053",
            "telephone_number": "847-967-5010",
            "fax_number": "847-967-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6131 W DEMPSTER",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "60053",
            "telephone_number": "847-967-5010",
            "fax_number": "847-967-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS OF THE NORTH SHORE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "PFEIFER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "847-967-5010"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01632926",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; 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.