Family Medicine Specialists, Inc

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

FAMILY MEDICINE SPECIALISTS, INC

Practice address

431 W Liberty St
Wauconda, IL 60084-2452

Phone

(847) 526-2151

NPI assigned

Mar 17, 2010

Organization subpart

Yes

Parent organization

FAMILY MEDICINE SPECIALISTS, INCAs reported in NPPES

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

Authorized official

Name

Jennifer Belluci-Jackson, M.D.

Title

Medical Director

Phone

(847) 526-2151

Specialties & licenses 1

Addresses

Tax ID family

Family Medicine Specialists2 organizations share this tax ID, including this one

Part of

Family Medicine Specialists

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Family Medicine Specialists, Inc.

  • Non-Pharmacy Dispensing Site
  • Richmond, IL
  • NPI 1841513678
  NPD tax ID

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298937600000",
    "number": "1497079636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-474-9809",
            "fax_number": "888-652-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 W LIBERTY ST",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600842452",
            "telephone_number": "847-526-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE SPECIALISTS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY MEDICINE SPECIALISTS, INC",
        "enumeration_date": "2010-03-17",
        "last_updated": "2011-03-01",
        "status": "A",
        "authorized_official_last_name": "BELLUCI-JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "847-526-2151",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daisi Duran
• Rose Henry Mariette Eboh, NP
• Kerry J Ehlert-Donovan, APN
• Employee Health Advocate LTD
• Carol A Exline
• Family Medicine Specialists, S.C.
• Family Medicine Specialists, S.C.
• Michael Ferrari, DPM
• Leslie D Ferrigan, P.T.
• First Step Foot Care, SC

• Non-Pharmacy Dispensing Site in Wauconda, IL
• Providers in Wauconda, IL by specialty
• Non-Pharmacy Dispensing Site in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.