Organization Active NPI

Midwest OB/GYN & Midwifery

  • Obstetrics & Gynecology Physician
  • Elk Grove Village, IL
National Provider Identifier
1790020006
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MIDWEST OB/GYN & MIDWIFERY
Practice address
800 Biesterfield Rd
Suite 306
Elk Grove Village, IL 60007-3361
Phone
(847) 357-1144
Fax
(847) 357-9449
NPI assigned
Nov 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Authorized official

Name
Ms. Jennifer M Moreira, M.D.
Title
OB/GYN
Phone
(847) 357-1144

Specialties & licenses 1

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

Addresses

Primary practice location

800 Biesterfield Rd
Suite 306
Elk Grove Village, IL 60007-3361

Mailing address

800 Biesterfield Rd
Suite 306
Elk Grove Village, IL 60007-3361
Phone (847) 357-1144

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140527000641 IL Part B Supplier - Clinic/Group Practice 2769605401 Receives reassigned benefits from 2 practitioners
Practice locations: Elk Grove Village, IL

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
14D1095282Midwest OB / GYN & Midwifery800 Biesterfield Rd, Ste 306, Elk Grove Village, IL 60007Provider-performed microscopyFeb 4, 2027

National Provider Directory

National Provider Directory

Locations

111 S Washington Ave
Ste 205
Park Ridge, IL 60068

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": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1790020006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "SUITE 306",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-357-1144",
            "fax_number": "847-357-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "SUITE 306",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-357-1144",
            "fax_number": "847-357-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST OB/GYN & MIDWIFERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "MOREIRA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OB/GYN",
        "authorized_official_telephone_number": "847-357-1144",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.