NPIMap

Organization Active NPI

Westside Rheumatology, Inc.

  • Rheumatology Physician
  • Chicago, IL
National Provider Identifier
1821315128
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036115006 Issued in IL
Legal business name
WESTSIDE RHEUMATOLOGY, INC.
Practice address
2875 W 19TH St
Chicago, IL 60623-3501
Phone
(773) 983-5785
Fax
(708) 423-9666
NPI assigned
Apr 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Authorized official

Name
Dr. Donald Massenburg, M.D.
Title
Physician
Phone
(773) 983-5785

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X 036115006 IL Primary

Addresses

Primary practice location

2875 W 19TH St
Chicago, IL 60623-3501

Mailing address

9449 S Kedzie Ave
Suite 317
Evergreen Park, IL 60805-2325
Phone (773) 983-5785

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272240000000",
    "number": "1821315128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9449 S KEDZIE AVE",
            "address_2": "SUITE 317",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052325",
            "telephone_number": "773-983-5785",
            "fax_number": "708-423-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 W 19TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233501",
            "telephone_number": "773-983-5785",
            "fax_number": "708-423-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE RHEUMATOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A",
        "authorized_official_last_name": "MASSENBURG",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "773-983-5785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036115006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; 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.