Organization Active NPI

Howard S Mangurten MDSC

  • Internal Medicine Physician
  • Hoffman Estates, IL
National Provider Identifier
1639219421
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HOWARD S MANGURTEN MDSC
Practice address
990 Grand Canyon Parkway
Suite 310
Hoffman Estates, IL 60169
Phone
(847) 884-8420
Fax
(847) 884-0198
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Authorized official

Name
Dr. Howard Sheldon Mangurten, MDNPI 1003990870
Title
President
Phone
(847) 884-8420

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X IL Primary

Addresses

Primary practice location

990 Grand Canyon Parkway
Suite 310
Hoffman Estates, IL 60169

Mailing address

990 Grand Canyon Parkway
Suite 310
Hoffman Estates, IL 60169
Phone (847) 884-8420

Other identifiers 4

IdentifierTypeStateIssuer
01628148OtherILBCBS
1003990870OtherNPI
31603504OtherILBCBS
1417055765OtherNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070529000319 IL Part B Supplier - Clinic/Group Practice 5294832101 Receives reassigned benefits from 2 practitioners
Practice locations: Hoffman Estates, IL

National Provider Directory

National Provider Directory

Locations

990 Grand Canyon Pkwy
Ste 310
Hoffman Estates, IL 60169
Phone (847) 884-8420

Practitioners & affiliated clinicians

Practitioners 2

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": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1639219421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 GRAND CANYON PARKWAY",
            "address_2": "SUITE 310",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "60169",
            "telephone_number": "847-884-8420",
            "fax_number": "847-884-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 GRAND CANYON PARKWAY",
            "address_2": "SUITE 310",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "60169",
            "telephone_number": "847-884-8420",
            "fax_number": "847-884-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOWARD S MANGURTEN MDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "MANGURTEN",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "SHELDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-884-8420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01628148",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1003990870",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31603504",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1417055765",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.