NPIMap

Organization Active NPI

Affiliated Ear, Nose and Throat Physicians

  • Otolaryngology Physician
  • Ingleside, IL
National Provider Identifier
1619012010
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
AFFILIATED EAR, NOSE AND THROAT PHYSICIANS
Practice address
214 Washington St
Ingleside, IL 60041-9208
Phone
(847) 587-4700
Fax
(847) 587-6034
NPI assigned
Feb 21, 2007
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Fay Wilson
Title
Practice Manager
Phone
(815) 338-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

214 Washington St
Ingleside, IL 60041-9208

Mailing address

2441 Lake Shore Dr
Woodstock, IL 60098-6911
Phone (815) 338-4600

National Provider Directory

National Provider Directory
Tax ID family
Affiliated Ear Nose and Throat Physicians2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2441 Lake Shore Dr
Woodstock, IL 60098
Phone (815) 338-4600

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1619012010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 LAKE SHORE DR",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600986911",
            "telephone_number": "815-338-4600",
            "fax_number": "815-338-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 WASHINGTON ST",
            "city": "INGLESIDE",
            "state": "IL",
            "postal_code": "600419208",
            "telephone_number": "847-587-4700",
            "fax_number": "847-587-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED EAR, NOSE AND THROAT PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "FAY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "815-338-4600"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ingleside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.