Marjorie Mintz Rosenbaum MD LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036065456 Issued in IL

Legal business name

MARJORIE MINTZ ROSENBAUM MD LLC

Practice address

676 N St Clair
Suite 1725
Chicago, IL 60611-2974

Phone

(312) 664-8533

Fax

(312) 664-8860

NPI assigned

Oct 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Marjorie Mintz Rosenbaum, MD

Title

Physician Owner

Phone

(312) 664-8533

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318204800000",
    "number": "1548449580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST",
            "address_2": "SUITE 1725",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112927",
            "telephone_number": "312-664-8533",
            "fax_number": "312-664-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N ST CLAIR",
            "address_2": "SUITE 1725",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112974",
            "telephone_number": "312-664-8533",
            "fax_number": "312-664-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARJORIE MINTZ ROSENBAUM MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2011-10-10",
        "status": "A",
        "authorized_official_last_name": "ROSENBAUM",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_middle_name": "MINTZ",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "312-664-8533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036065456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PROVIDER NO.",
            "identifier": "204237",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mark a Szymanski, DCPC
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• Mark D. Berger, M.D., S.C.
• Mark Gindi MD SC
• Mark Harvey MDSC

• Dermatology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.