Organization Active NPI

Signature Medical Associates, SC

  • Internal Medicine Physician
  • Elgin, IL
National Provider Identifier
1750306247
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036073467 Issued in IL
Legal business name
SIGNATURE MEDICAL ASSOCIATES, SC
Practice address
1710 N Randall Rd
Suite 200
Elgin, IL 60123-9400
Phone
(847) 214-5738
Fax
(547) 214-5757
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Authorized official

Name
Dr. Marlyn Valena, MD
Title
President
Phone
(847) 214-5738

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 036073467 IL Primary

Addresses

Primary practice location

1710 N Randall Rd
Suite 200
Elgin, IL 60123-9400

Mailing address

7476 Solutions Ctr
Chicago, IL 60677-7004
Phone (847) 214-9611

Other identifiers 1

IdentifierTypeStateIssuer
DB0387OtherILMEDICARE PIN - RAIL ROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

7476 Solutions Ctr
Chicago, IL 60677

750 S State St
Elgin, IL 60123
Phone (847) 742-1040

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377561600000",
    "number": "1750306247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7476 SOLUTIONS CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606777004",
            "telephone_number": "847-214-9611",
            "fax_number": "847-214-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 N RANDALL RD",
            "address_2": "SUITE 200",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601239400",
            "telephone_number": "847-214-5738",
            "fax_number": "547-214-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE MEDICAL ASSOCIATES, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2013-08-27",
        "status": "A",
        "authorized_official_last_name": "VALENA",
        "authorized_official_first_name": "MARLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-214-5738",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036073467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN - RAIL ROAD MEDICARE",
            "identifier": "DB0387",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.