Maranatha Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036063544 Issued in IL

Legal business name

MARANATHA FAMILY MEDICINE

Practice address

550 N Midlothian Rd
Mundelein, IL 60060-1613

Phone

(847) 949-8474

Fax

(847) 949-4825

NPI assigned

Apr 21, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Chester Gregory Laskowski, M.D.NPI 1508856550

Title

Owner

Phone

(847) 949-8474

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chester G Laskowski, M.D.

  • Family Medicine Physician
  • Lakemoor, IL
  • NPI 1508856550
  NPD (past) Authorized official

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1487898417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 N MIDLOTHIAN RD",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601613",
            "telephone_number": "847-949-8474",
            "fax_number": "847-949-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N MIDLOTHIAN RD",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601613",
            "telephone_number": "847-949-8474",
            "fax_number": "847-949-4825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARANATHA FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "LASKOWSKI",
        "authorized_official_first_name": "CHESTER",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-949-8474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036063544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Mundelein, IL
• Providers in Mundelein, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.