Logan General Medical Center Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1768840 Issued in IL

Legal business name

LOGAN GENERAL MEDICAL CENTER INC

Practice address

2734 N Milwaukee Ave
150
Chicago, IL 60647-1362

Phone

(773) 384-2445

Fax

(773) 384-1155

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Rosangel Perez

Title

President

Phone

(773) 384-2445

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497834139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2734 N MILWAUKEE AVE",
            "address_2": "150",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471362",
            "telephone_number": "773-384-2445",
            "fax_number": "773-384-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2734 N MILWAUKEE AVE",
            "address_2": "150",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471362",
            "telephone_number": "773-384-2445",
            "fax_number": "773-384-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN GENERAL MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ROSANGEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-384-2445"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "1768840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Loftspring, MD
• Kirsten Virginia Loftus, M.D.
• Mary Rose Loftus, DO
• Timothy Michael Loftus, M.D.
• Logan Authorization
• Logan Square Acupuncture, LLC
• Logan Square Anesthesia PC
• Logan Square Counseling LLC
• Logan Square Dental Service Center
• Logan Square Foot Center

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, 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 Aug 22, 2020; 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.