Organization Active NPI

Burr Ridge Family Practice , LTD.

  • Family Medicine Physician
  • Hinsdale, IL
National Provider Identifier
1790891877
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BURR RIDGE FAMILY PRACTICE , LTD.
Practice address
11 Salt Creek LN Ste 125
Hinsdale, IL 60521-2902
Phone
(630) 655-1177
NPI assigned
Aug 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mrs. Porfira Ciungan
Title
Arspecialist
Phone
(847) 735-9330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

11 Salt Creek LN Ste 125
Hinsdale, IL 60521-2902

Mailing address

11 Salt Creek LN Ste 125
Hinsdale, IL 60521-2902
Phone (630) 655-1177

Other identifiers 1

IdentifierTypeStateIssuer
2232216OtherILBC/BS OF IL PROVIDER #

National Provider Directory

National Provider Directory

Locations

7630 S County Line Rd
Burr Ridge, IL 60527
Phone (630) 321-3555

11 Salt Creek Ln
Ste 125
Hinsdale, IL 60521
Phone (630) 655-1177

545 Plainfield Rd
Bldg 2S
Willowbrook, IL 60527

Practitioners & affiliated clinicians

Practitioners 5

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": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1790891877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SALT CREEK LN STE 125",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212902",
            "telephone_number": "630-655-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SALT CREEK LN STE 125",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212902",
            "telephone_number": "630-655-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURR RIDGE FAMILY PRACTICE , LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "CIUNGAN",
        "authorized_official_first_name": "PORFIRA",
        "authorized_official_title_or_position": "ARSPECIALIST",
        "authorized_official_telephone_number": "847-735-9330",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF IL PROVIDER #",
            "identifier": "2232216",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.