Childrens Gastroenterology Specialists SC

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

Legal business name

CHILDRENS GASTROENTEROLOGY SPECIALISTS SC

Practice address

2551 Compass Rd
Suite 110
Glenview, IL 60026-8045

Phone

(847) 724-7825

Fax

(847) 724-7845

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Suzanne P Nelson, MD

Title

Sole Proprietor

Phone

(847) 724-7825

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1699874255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 OAKMONT LN",
            "address_2": "SUITE 1600",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595511",
            "telephone_number": "630-789-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 COMPASS RD",
            "address_2": "SUITE 110",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268045",
            "telephone_number": "847-724-7825",
            "fax_number": "847-724-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS GASTROENTEROLOGY SPECIALISTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "847-724-7825",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "1634323",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Gastroenterology Physician in Glenview, IL
• Providers in Glenview, IL by specialty
• Pediatric Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.