Gold Coast Osteopathic, PSC

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

Legal business name

GOLD COAST OSTEOPATHIC, PSC

Practice address

680 N Lake Shore Dr Ste 1040
Chicago, IL 60611-8718

Phone

(773) 554-6055

NPI assigned

Jul 1, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Aida BeckerlyNPI 1508188111

Title

President

Phone

(773) 554-6055

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aida Beckerly, D.O.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1508188111
  NPD (past) Authorized official

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473724800000",
    "number": "1750733788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 1040",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "773-554-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 1040",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606118718",
            "telephone_number": "773-554-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST OSTEOPATHIC, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-01",
        "last_updated": "2016-09-13",
        "status": "A",
        "authorized_official_last_name": "BECKERLY",
        "authorized_official_first_name": "AIDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-554-6055",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS STATE",
            "identifier": "1568816254",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gold Coast Gynecology Surgery SC
• Gold Coast Internal Medicine
• Gold Coast Orthopaedic and Spine Surgery S C
• Gold Coast Orthopaedic and Spine Surgery SC
• Gold Coast Osteopathic, PSC
• Gold Coast Plastic Surgery LLC
• Gold Coast Podiatry Center, LLC
• Gold Coast Podiatry Center, LLC
• Gold Coast Podiatry Center, LLC
• Gold Coast Podiatry Center, LLC

• Neuromusculoskeletal Medicine & OMM Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; 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.