Northside Neurosurgery, LLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

NORTHSIDE NEUROSURGERY, LLC

Practice address

3000 N Halsted St
Suite 605
Chicago, IL 60657-5188

Phone

(773) 348-4333

Fax

(773) 348-2434

NPI assigned

Oct 5, 2010

Last updated

Jun 17, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Betsy M Matthews

Title

Chief Financial Officer

Phone

(847) 990-1463

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jonathan S Citow, MD

  • Neurological Surgery Physician
  • Libertyville, IL
  • NPI 1093703571
  NPD (past)

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1710296934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 S MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483279",
            "telephone_number": "847-362-1848",
            "fax_number": "847-362-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST",
            "address_2": "SUITE 605",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575188",
            "telephone_number": "773-348-4333",
            "fax_number": "773-348-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE NEUROSURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "847-990-1463"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northside Dermatology, S.C.
• Northside Foot & Ankle PC
• Northside Foot & Ankle PC
• Northside Lab Inc
• Northside Neonatal and Infant Care SC
• Northside Physical Therapy
• Northside Physical Therapy
• Northside Psychology Services PLLC
• Northside Rheumatology PLLC
• Northside Speech Solutions P.C.

• Neurological Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Neurological Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.