NPIMap

Organization Active NPI

Suburban Womens Health Specialists LTD

  • Obstetrics & Gynecology Physician
  • Elgin, IL
National Provider Identifier
1780739698
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
042007882 Issued in IL
Legal business name
SUBURBAN WOMENS HEALTH SPECIALISTS LTD
Practice address
2350 Royal Blvd
Suite 600
Elgin, IL 60123-4719
Phone
(847) 931-4747
Fax
(847) 931-9602
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Authorized official

Name
Marilyn Gray
Title
Practice Manager
Phone
(847) 931-4747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 042007882 IL Primary

Addresses

Primary practice location

2350 Royal Blvd
Suite 600
Elgin, IL 60123-4719

Mailing address

2350 Royal Blvd
Suite 600
Elgin, IL 60123-4719
Phone (847) 931-4747

Other identifiers 2

IdentifierTypeStateIssuer
036064786MedicaidIL
036093466MedicaidIL

Electronic endpoints 8

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address mmiller287573@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address bepstein287576@direct.myadvocateaurora.org Direct
Direct Messaging Address cmichael288346@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address cvolkening287663@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060424000412 IL Part B Supplier - Clinic/Group Practice 6709896590 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elgin, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

600 S Randall Rd
Ste 110
Algonquin, IL 60102
Phone (847) 731-4747

2971 W Algonquin Rd
Ste 107
Algonquin, IL 60102
Phone (847) 458-2400

2971 W Algonquin Rd
Ste 107A
Algonquin, IL 60102
Phone (847) 372-5046

2350 Royal Blvd
Ste 600
Elgin, IL 60123
Phone (847) 931-4747

Interoperability endpoints

  • Direct secure messaging: cvolkening287663@direct.myadvocateaurora.org
  • Direct secure messaging: mmiller287573@direct.myadvocateaurora.org
  • Direct secure messaging: bepstein287576@direct.myadvocateaurora.org

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640044800000",
    "number": "1780739698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 ROYAL BLVD",
            "address_2": "SUITE 600",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234719",
            "telephone_number": "847-931-4747",
            "fax_number": "847-931-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 ROYAL BLVD",
            "address_2": "SUITE 600",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234719",
            "telephone_number": "847-931-4747",
            "fax_number": "847-931-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN WOMENS HEALTH SPECIALISTS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "847-931-4747"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "042007882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064786",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093466",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2350 Royal Blvd",
            "address_2": "Suite 600",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601234719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmiller287573@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2350 Royal Blvd",
            "address_2": "Suite 600",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601234719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2350 Royal Blvd",
            "address_2": "Suite 600",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601234719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2350 Royal Blvd",
            "address_2": "Suite 600",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601234719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bepstein287576@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2350 Royal Blvd",
            "address_2": "Suite 600",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601234719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmichael288346@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2350 Royal Blvd",
            "address_2": "Suite 600",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601234719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2350 Royal Blvd",
            "address_2": "Suite 600",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601234719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cvolkening287663@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2350 Royal Blvd",
            "address_2": "Suite 600",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601234719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 21, 2021; 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.

Verify at the official NPI Registry.