Organization Active NPI

Quality Primary Care PC

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1700839719
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
QUALITY PRIMARY CARE PC
Practice address
8541 S State St
Chicago, IL 60619-5665
Phone
(773) 488-2200
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Authorized official

Name
Niva Lubin Johnson, MD
Title
Ceo
Phone
(773) 488-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X IL Primary

Addresses

Primary practice location

8541 S State St
Chicago, IL 60619-5665

Mailing address

8541 S State St
Chicago, IL 60619-5665
Phone (773) 488-2200

Other identifiers 1

IdentifierTypeStateIssuer
1700839719OtherILMEDICARE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357084800000",
    "number": "1700839719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8541 S STATE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606195665",
            "telephone_number": "773-488-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8541 S STATE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606195665",
            "telephone_number": "773-488-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2013-01-02",
        "status": "A",
        "authorized_official_last_name": "LUBIN JOHNSON",
        "authorized_official_first_name": "NIVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-488-2200",
        "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": "MEDICARE",
            "identifier": "1700839719",
            "state": "IL"
        }
    ],
    "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 Jan 2, 2013; 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.