Organization Active NPI

Northwest Brain and Spine Surgery, S.C.

  • Neurological Surgery Physician
  • Elgin, IL
National Provider Identifier
1629188701
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
NORTHWEST BRAIN AND SPINE SURGERY, S.C.
Practice address
1425 N McLean Blvd
Ste 550
Elgin, IL 60123-5723
Phone
(847) 741-1610
Fax
(847) 741-1798
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Safwan Barakat, M.D.NPI 1194833632
Title
Owner
Phone
(847) 741-1610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X IL Primary

Addresses

Primary practice location

1425 N McLean Blvd
Ste 550
Elgin, IL 60123-5723

Mailing address

1425 N McLean Blvd
Ste 550
Elgin, IL 60123-5723
Phone (847) 741-1610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120131000411 IL Part B Supplier - Clinic/Group Practice 4688831811 Receives reassigned benefits from 1 practitioner
Practice locations: Elgin, IL

National Provider Directory

National Provider Directory

Locations

1425 N McLean Blvd
Ste 550
Elgin, IL 60123
Phone (847) 741-1610

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAFCAA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629188701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 N MCLEAN BLVD",
            "address_2": "STE 550",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235723",
            "telephone_number": "847-741-1610",
            "fax_number": "847-741-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 N MCLEAN BLVD",
            "address_2": "STE 550",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235723",
            "telephone_number": "847-741-1610",
            "fax_number": "847-741-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST BRAIN AND SPINE SURGERY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARAKAT",
        "authorized_official_first_name": "SAFWAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-741-1610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.