Winchester Medical Group, S.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036064653 Issued in IL

Legal business name

WINCHESTER MEDICAL GROUP, S.C.

Practice address

1268 American Way
Libertyville, IL 60048-3936

Phone

(847) 367-6400

Fax

(847) 367-6888

NPI assigned

Jul 1, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Vicki A Reynolds, R.N.

Title

Administrator

Phone

(847) 680-1822

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246406400000",
    "number": "1497983191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 AMERICAN WAY",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483936",
            "telephone_number": "847-367-6400",
            "fax_number": "847-367-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 AMERICAN WAY",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483936",
            "telephone_number": "847-367-6400",
            "fax_number": "847-367-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINCHESTER MEDICAL GROUP, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-01",
        "last_updated": "2009-07-01",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-680-1822",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036064653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Wilson, SLP
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• Winchester Ambulatory Surgery Center LLC
• Winchester Endoscopy Center
• Winchester Endoscopy, LLC
• Windy City Medical Specialists, LLC
• Peggy Wingo, PH.D.,LLC
• Emily Rose Winkler
• Caroline M Winters, DPT
• Wisz & Katz Enterprises PC

• Internal Medicine Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Internal Medicine Physician in Illinois

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