Zion Medical Group and Associates LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036-127152 Issued in IL

Legal business name

ZION MEDICAL GROUP AND ASSOCIATES LLC

Practice address

2261 Misty Creek TRL
Bolingbrook, IL 60490-5048

Phone

(630) 906-5120

NPI assigned

Sep 26, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy A Brown, M.D.

Title

Owner

Phone

(630) 906-5120

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1720481302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 MISTY CREEK TRL",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905048",
            "telephone_number": "630-906-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2261 MISTY CREEK TRL",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905048",
            "telephone_number": "630-906-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZION MEDICAL GROUP AND ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-906-5120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-127152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.