NPIMap

Organization Active NPI

Northwestern Perinatal Associates, S.C.

  • Maternal & Fetal Medicine Physician
  • Chicago, IL
National Provider Identifier
1457565426
Registry record updated Apr 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
036-058725 Issued in IL
Legal business name
NORTHWESTERN PERINATAL ASSOCIATES, S.C.
Practice address
680 N Lake Shore Drive
Suite 1428
Chicago, IL 60611-8700
Phone
(312) 981-4350
Fax
(312) 981-4363
NPI assigned
May 9, 2007
Last updated
Apr 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2010

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

Authorized official

Name
Ms. Judi L Gretz, RN
Title
Practice Manager
Phone
(312) 981-4350

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X 036-058725 IL
Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VH0002X 036058725 IL
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X 036-058725 IL Primary
Obstetrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0000X 036-058725 IL

Addresses

Primary practice location

680 N Lake Shore Drive
Suite 1428
Chicago, IL 60611-8700

Mailing address

680 N Lake Shore Drive
Suite 1428
Chicago, IL 60611-8700
Phone (312) 981-4350

Other identifiers 1

IdentifierTypeStateIssuer
036058725MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272326400000",
    "number": "1457565426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DRIVE",
            "address_2": "SUITE 1428",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606118700",
            "telephone_number": "312-981-4350",
            "fax_number": "312-981-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DRIVE",
            "address_2": "SUITE 1428",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606118700",
            "telephone_number": "312-981-4350",
            "fax_number": "312-981-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN PERINATAL ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2010-04-27",
        "status": "A",
        "authorized_official_last_name": "GRETZ",
        "authorized_official_first_name": "JUDI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "312-981-4350",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036-058725",
            "primary": false
        },
        {
            "code": "207VH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
            "state": "IL",
            "license": "036058725",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "IL",
            "license": "036-058725",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "IL",
            "license": "036-058725",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058725",
            "state": "IL"
        }
    ],
    "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 Apr 27, 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.