NPIMap

Organization Active NPI

Waukegan Illinois Hospital Company LLC

  • Nutritionist
  • Waukegan, IL
National Provider Identifier
1841335932
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Legal business name
WAUKEGAN ILLINOIS HOSPITAL COMPANY LLC
Practice address
1324 N Sheridan Rd
Waukegan, IL 60085-2161
Phone
(847) 360-2392
Fax
(847) 782-3945
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gary D Newsome
Title
President
Phone
(615) 465-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X Primary

Addresses

Primary practice location

1324 N Sheridan Rd
Waukegan, IL 60085-2161

Mailing address

1324 N Sheridan Rd
Waukegan, IL 60085-2161
Phone (847) 360-2392

Other names 1

  • Vista Medical Center East Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841335932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-2392",
            "fax_number": "847-782-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-2392",
            "fax_number": "847-782-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUKEGAN ILLINOIS HOSPITAL COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEWSOME",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-465-7000"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Medical Center East",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waukegan, IL

Sources for this page

  • 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.