NPIMap

Organization Active NPI

Novamed Surgery Center of Chicago-Northshore, LLC

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1447255799
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
NOVAMED SURGERY CENTER OF CHICAGO-NORTHSHORE, LLC
Practice address
3034 W Peterson Ave
Chicago, IL 60659-3729
Phone
(773) 973-7432
Fax
(773) 973-4134
NPI assigned
Jun 14, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X IL Primary

Addresses

Primary practice location

3034 W Peterson Ave
Chicago, IL 60659-3729

Mailing address

3034 W Peterson Ave
Chicago, IL 60659-3729
Phone (773) 973-7432

Other identifiers 1

IdentifierTypeStateIssuer
DA0181OtherRR MEDICARE

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

7027 Reliable Pkwy
Chicago, IL 60686

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1447255799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3034 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593729",
            "telephone_number": "773-973-7432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3034 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593729",
            "telephone_number": "773-973-7432",
            "fax_number": "773-973-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVAMED SURGERY CENTER OF CHICAGO-NORTHSHORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-14",
        "last_updated": "2022-07-21",
        "certification_date": "2021-05-11",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5900"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DA0181",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 21, 2022; 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.