Organization Active NPI

Healthguard Medical Network SC

  • Pediatric Adolescent Medicine Physician
  • Saint Charles, IL
National Provider Identifier
1831280783
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
HEALTHGUARD MEDICAL NETWORK SC
Practice address
40W222 la Fox Road
Suite K
Saint Charles, IL 60175-7625
Phone
(630) 443-7000
Fax
(630) 443-7590
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Authorized official

Name
Mr. Cameron Safarloo
Title
Ceo
Phone
(630) 907-6009

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X IL
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X IL Primary

Addresses

Primary practice location

40W222 la Fox Road
Suite K
Saint Charles, IL 60175-7625

Mailing address

1205 Oak Street
North Aurora, IL 60542-2006
Phone (630) 907-6009

Other names 1

  • Healthguard Pediatric And Adult Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

40W222 Lafox Rd
Ste J
St Charles, IL 60175

Practitioners & affiliated clinicians

Practitioners 3

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": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188259200000",
    "number": "1831280783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 OAK STREET",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605422006",
            "telephone_number": "630-907-6009",
            "fax_number": "630-907-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40W222 LA FOX ROAD",
            "address_2": "SUITE K",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601757625",
            "telephone_number": "630-443-7000",
            "fax_number": "630-443-7590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHGUARD MEDICAL NETWORK SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-08-28",
        "status": "A",
        "authorized_official_last_name": "SAFARLOO",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "630-907-6009",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthguard Pediatric And Adult Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.