NPIMap

Organization Active NPI

Orthopaedics & Rheumatology of the North Shore

  • Medical Specialty Clinic/Center
  • Skokie, IL
National Provider Identifier
1811371990
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
1619032109 Issued in IL
Legal business name
ORTHOPAEDICS & RHEUMATOLOGY OF THE NORTH SHORE
Practice address
4709 Golf Rd
Suite 1200
Skokie, IL 60076-1231
Phone
(847) 869-7233
Fax
(847) 869-9461
NPI assigned
Jul 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Mr. James Pekarek
Title
Practice Administrator
Phone
(847) 869-7233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 1619032109 IL Primary

Addresses

Primary practice location

4709 Golf Rd
Suite 1200
Skokie, IL 60076-1231

Mailing address

4709 Golf Rd
Suite 1200
Skokie, IL 60076-1231
Phone (847) 869-7233

Other identifiers 4

IdentifierTypeStateIssuer
036040690MedicaidIL
036104339MedicaidIL
036043731MedicaidIL
036099046MedicaidIL

Other names 1

  • Orthopaedics of the North Shore Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Orthopaedics of the North Shore3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1811371990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD",
            "address_2": "SUITE 1200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761231",
            "telephone_number": "847-869-7233",
            "fax_number": "847-869-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD",
            "address_2": "SUITE 1200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761231",
            "telephone_number": "847-869-7233",
            "fax_number": "847-869-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDICS & RHEUMATOLOGY OF THE NORTH SHORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "PEKAREK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "847-869-7233",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "1619032109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036040690",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104339",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036043731",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099046",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthopaedics of the North Shore",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.