NPIMap

Organization Active NPI

North Suburban Pediatrics, SC

  • Pediatrics Physician
  • Evanston, IL
National Provider Identifier
1780729145
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NORTH SUBURBAN PEDIATRICS, SC
Practice address
2530 Ridge Ave
Suite 201
Evanston, IL 60201-2492
Phone
(847) 869-0892
Fax
(847) 869-1070
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Kelly A Kirschbaum
Title
Office Manager
Phone
(847) 869-6485

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X IL Primary

Addresses

Primary practice location

2530 Ridge Ave
Suite 201
Evanston, IL 60201-2492

Mailing address

2530 Ridge Ave
Suite 201
Evanston, IL 60201-2492
Phone (847) 869-0892

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0868396North Suburban Pediatrics2530 Ridge Avenue, Evanston, IL 60201AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Locations

1431 McHenry Rd
Ste 107
Buffalo Grove, IL 60089

2530 Ridge Ave
Ste 201
Evanston, IL 60201
Phone (847) 869-0892

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780729145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 RIDGE AVE",
            "address_2": "SUITE 201",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012492",
            "telephone_number": "847-869-0892",
            "fax_number": "847-869-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 RIDGE AVE",
            "address_2": "SUITE 201",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012492",
            "telephone_number": "847-869-0892",
            "fax_number": "847-869-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUBURBAN PEDIATRICS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIRSCHBAUM",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-869-6485",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.