Organization Active NPI

Streamwood Family Medical Center, PC

  • Internal Medicine Physician
  • Streamwood, IL
National Provider Identifier
1417070988
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
STREAMWOOD FAMILY MEDICAL CENTER, PC
Practice address
403 W Irving Park Rd
Streamwood, IL 60107-2851
Phone
(630) 830-1900
Fax
(630) 830-1904
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Authorized official

Name
Dr. Alan James Brongiel, M.D.
Title
Administrator
Phone
(630) 830-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

403 W Irving Park Rd
Streamwood, IL 60107-2851

Mailing address

403 W Irving Park Rd
Streamwood, IL 60107-2851
Phone (630) 830-1900

Other identifiers 1

IdentifierTypeStateIssuer
01615242OtherILBLUECROSS BLUESHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1417070988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W IRVING PARK RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072851",
            "telephone_number": "630-830-1900",
            "fax_number": "630-830-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W IRVING PARK RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072851",
            "telephone_number": "630-830-1900",
            "fax_number": "630-830-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STREAMWOOD FAMILY MEDICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "BRONGIEL",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "630-830-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "01615242",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Streamwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.