NPIMap

Organization Active NPI

Gold Coast Gynecology Surgery SC

  • Gynecology Physician
  • Chicago, IL
National Provider Identifier
1669622775
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
036057210 Issued in IL
Legal business name
GOLD COAST GYNECOLOGY SURGERY SC
Practice address
680 N Lake Shore Dr
Suite 830
Chicago, IL 60611-4546
Phone
(312) 440-1600
NPI assigned
Sep 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Authorized official

Name
Maureen L Pendl
Title
Billing Manager
Phone
(312) 440-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X 036057210 IL Primary

Addresses

Primary practice location

680 N Lake Shore Dr
Suite 830
Chicago, IL 60611-4546

Mailing address

680 N Lake Shore Dr
Suite 830
Chicago, IL 60611-4546
Phone (312) 440-1600

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222300800000",
    "number": "1669622775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 830",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-440-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 830",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-440-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST GYNECOLOGY SURGERY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-25",
        "last_updated": "2008-09-25",
        "status": "A",
        "authorized_official_last_name": "PENDL",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "312-440-1600"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036057210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.