Northwest Ambucare

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

NORTHWEST AMBUCARE

Practice address

4040 W Peterson Ave
Chicago, IL 60646-6019

Phone

(773) 267-0554

Fax

(773) 267-6258

NPI assigned

Mar 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Tegan Augustine Thimesch, DPM

Title

President

Phone

(773) 267-0554

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811965635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466019",
            "telephone_number": "773-267-0554",
            "fax_number": "773-267-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466019",
            "telephone_number": "773-267-0554",
            "fax_number": "773-267-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST AMBUCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THIMESCH",
        "authorized_official_first_name": "TEGAN",
        "authorized_official_middle_name": "AUGUSTINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-267-0554",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northstar Restorative Counseling LLC
• Northstar Therapy in Northbrook
• Northtown Drugs
• Northwest Adult Wellness Center LLC
• Northwest Advanced Surgical Associates, SC
• Northwest Anesthesiologists, S.C.
• Northwest Chicago Medical LTD
• Northwest Chicago Primary Care SC
• Northwest Chiropractix Inc.
• Northwest Dentistry

• Podiatric Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Podiatric Clinic/Center in Illinois

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.