Anor Medical Center, Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

1742318 Issued in IL

Legal business name

ANOR MEDICAL CENTER, INC

Practice address

5241 W Diversey Ave
Chicago, IL 60639-1501

Phone

(773) 637-1775

Fax

(773) 637-1775

NPI assigned

Nov 1, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Orlando Paulino Gonzalez

Title

President

Phone

(773) 637-1775

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193875200000",
    "number": "1659550002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5241 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391501",
            "telephone_number": "773-637-1775",
            "fax_number": "773-637-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5241 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391501",
            "telephone_number": "773-637-1775",
            "fax_number": "773-637-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANOR MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2007-11-01",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ORLANDO",
        "authorized_official_middle_name": "PAULINO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-637-1775",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "1742318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS AND BLUE SHIELD",
            "identifier": "0001637066",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Chicago, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.