Jaana Kristiina Avramidis, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

036.094588 Issued in IL

Practice address

2400 Belvidere Road
Waukegan, IL 60085

Phone

(847) 377-8400

Fax

(847) 984-5619

NPI assigned

Oct 4, 2005

Last updated

Dec 31, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1720075740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVENUE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "60085",
            "telephone_number": "847-377-8546",
            "fax_number": "847-377-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 BELVIDERE ROAD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "60085",
            "telephone_number": "847-377-8400",
            "fax_number": "847-984-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVRAMIDIS",
        "first_name": "JAANA",
        "middle_name": "KRISTIINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-094588",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036.094588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094588",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.