San Fernando Healthcare Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SAN FERNANDO HEALTHCARE INC

Practice address

505 N Wolf Rd
Wheeling, IL 60090-3027

Phone

(847) 808-0017

Fax

(847) 305-2533

NPI assigned

Oct 29, 2012

Organization subpart

No

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

Authorized official

Name

Vladimir Neverovskiy

Title

Owner

Phone

(847) 808-0017

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351468800000",
    "number": "1821342916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N WOLF RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903027",
            "telephone_number": "847-808-0017",
            "fax_number": "847-305-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N WOLF RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903027",
            "telephone_number": "847-808-0017",
            "fax_number": "847-305-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN FERNANDO HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2012-10-29",
        "status": "A",
        "authorized_official_last_name": "NEVEROVSKIY",
        "authorized_official_first_name": "VLADIMIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-808-0017"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Wheeling, IL
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• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; 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.