NPIMap

Organization Active NPI

North Shore Vein Clinics LLC

  • Vascular Surgery Physician
  • Northbrook, IL
National Provider Identifier
1841547098
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
NORTH SHORE VEIN CLINICS LLC
Practice address
4141 Dundee Rd
Northbrook, IL 60062
Phone
(847) 897-6868
Fax
(888) 621-3330
NPI assigned
Aug 7, 2012
Last updated
May 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Authorized official

Name
Dr. Yan Katsnelson, MDNPI 1285672840
Title
Manager
Phone
(847) 897-6868

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X NU Primary

Addresses

Primary practice location

4141 Dundee Rd
Northbrook, IL 60062

Mailing address

PO Box 451
Northbrook, IL 60065-0451
Phone (847) 897-6868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130626000912 IL Part B Supplier - Clinic/Group Practice 8123267978 Receives reassigned benefits from 20 practitioners
Practice locations: Northbrook, IL; Mundelein, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1841547098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650451",
            "telephone_number": "847-897-6868",
            "fax_number": "888-621-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 DUNDEE RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "60062",
            "telephone_number": "847-897-6868",
            "fax_number": "888-621-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE VEIN CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-07",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "KATSNELSON",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-897-6868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.