Active NPI
LG Care PC
- Adult Health Nurse Practitioner
- Northbrook, IL
National Provider Identifier
1740690494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 209.006769
- Legal business name
- LG CARE PC
- Practice address
- 1910 Landwehr Rd
Northbrook, IL 60062-5163 - Phone
- (847) 293-7375
- Fax
- (847) 400-0881
- NPI assigned
- May 3, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Leon Gurvich, ANP,MS, CWS
- Title
- Owner
- Phone
- (847) 293-7375
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 209.006769 | IL | Primary |
Addresses
Primary practice location
1910 Landwehr Rd
Northbrook, IL 60062-5163
Mailing address
1910 Landwehr Rd
Northbrook, IL 60062-5163
Phone (847) 293-7375
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 331022542001 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
2534 Elim Ave
Zion, IL 60099
Phone (847) 328-6503
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Adult Health Nurse Practitioner
- Northbrook, IL
- NPI 1659550374
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399075200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1733875200000",
"number": "1740690494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1910 LANDWEHR RD",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600625163",
"telephone_number": "847-293-7375",
"fax_number": "847-400-0881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 LANDWEHR RD",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600625163",
"telephone_number": "847-293-7375",
"fax_number": "847-400-0881"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LG CARE PC",
"organizational_subpart": "NO",
"enumeration_date": "2014-05-03",
"last_updated": "2024-12-11",
"certification_date": "2024-12-11",
"status": "A",
"authorized_official_last_name": "GURVICH",
"authorized_official_first_name": "LEON",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "847-293-7375",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "ANP,MS, CWS"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": "IL",
"license": "209.006769",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "331022542001",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.