NPIMap

Organization Active NPI

Northwestern Memorial Healthcare

  • Family Medicine Physician
  • Dekalb, IL
National Provider Identifier
1780155879
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHWESTERN MEMORIAL HEALTHCARE
Practice address
385 Wirtz Drive
Dekalb, IL 60115
Phone
(952) 653-2565
Fax
(952) 653-2540
NPI assigned
Dec 16, 2018
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Vernita Jorden
Title
DO
Phone
(312) 926-4843

National Provider Directory

National Provider Directory
Tax ID family
Northwestern Memorial Healthcare20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

541 N Fairbanks Ct
Ste 2600
Chicago, IL 60611

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

385 Wirtz Drive
Dekalb, IL 60115

Mailing address

385 Wirtz Drive
Dekalb, IL 60115
Phone (952) 653-2565

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 16, 2018.

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544918400000",
    "number": "1780155879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 WIRTZ DRIVE",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "60115",
            "telephone_number": "952-653-2565",
            "fax_number": "952-653-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 WIRTZ DRIVE",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "60115",
            "telephone_number": "952-653-2565",
            "fax_number": "952-653-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEMORIAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A",
        "authorized_official_last_name": "JORDEN",
        "authorized_official_first_name": "VERNITA",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "312-926-4843"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.