Gold Coast Osteopathic, PSC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GOLD COAST OSTEOPATHIC, PSC

Practice address

680 N Lake Shore Dr
Suite 1040
Chicago, IL 60611-4546

Phone

(773) 554-6055

NPI assigned

Apr 19, 2016

Last updated

Apr 19, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Aida BeckerlyNPI 1508188111

Title

President

Phone

(773) 553-6055

Specialties & licenses 8

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Aida Beckerly, D.O.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1508188111
  NPD (past) Authorized official

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461024000000",
    "number": "1568816254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 1040",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606118718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 1040",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "773-554-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST OSTEOPATHIC, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-04-19",
        "status": "A",
        "authorized_official_last_name": "BECKERLY",
        "authorized_official_first_name": "AIDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-553-6055",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MA",
            "license": "243290",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "IN",
            "license": "02004367B",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NY",
            "license": "261752",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "243290",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02004367A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "261752",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gold Coast Diagnostic Services, Inc.
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• Gold Coast Internal Medicine
• Gold Coast Orthopaedic and Spine Surgery S C
• Gold Coast Orthopaedic and Spine Surgery SC
• Gold Coast Osteopathic, PSC
• Gold Coast Plastic Surgery LLC
• Gold Coast Podiatry Center, LLC
• Gold Coast Podiatry Center, LLC
• Gold Coast Podiatry Center, LLC

• 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 Apr 19, 2016; 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.