North Shore Physicians Group, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036098890 Issued in IL

Legal business name

NORTH SHORE PHYSICIANS GROUP, LLC

Practice address

310 Happ Rd
Suite 207
Northfield, IL 60093-3455

Phone

(847) 784-5200

NPI assigned

Sep 22, 2009

Organization subpart

Yes

Parent organization

NORTH SHORE PHYSICIANS GROUP, LLCAs reported in NPPES

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

Authorized official

Name

Dr. John E Croghan, M.D.

Title

Physician/President

Phone

(847) 251-1500

Specialties & licenses 1

Addresses

Part of

North Shore Phys Group

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253577600000",
    "number": "1619201894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 HAPP RD",
            "address_2": "SUITE 207",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933455",
            "telephone_number": "847-784-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HAPP RD",
            "address_2": "SUITE 207",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933455",
            "telephone_number": "847-784-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE PHYSICIANS GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH SHORE PHYSICIANS GROUP, LLC",
        "enumeration_date": "2009-09-22",
        "last_updated": "2009-09-22",
        "status": "A",
        "authorized_official_last_name": "CROGHAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "847-251-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036098890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Rose PLLC
• Adam Nielander
• North Shore Adolescent Recovery Center
• North Shore Center for Facial Plastic and Cosmetic Surgery
• North Shore Counseling and Psychotherapy
• North Shore Senior Center
• North Shore Vascular Associates LTD
• Northfield Vision Center LLC
• Northview Dental Assocs
• Diana Nunez

• Internal Medicine Physician in Northfield, IL
• Providers in Northfield, 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 Sep 22, 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.