Organization Active NPI

Norybdeer Limited

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1851328546
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORYBDEER LIMITED
Practice address
45 W 111TH St
Suite B
Chicago, IL 60628-4247
Phone
(773) 370-5254
NPI assigned
Jun 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Ms. Shirley Walker
Title
Ceo
Phone
(708) 345-9894

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X IL Primary

Addresses

Primary practice location

45 W 111TH St
Suite B
Chicago, IL 60628-4247

Mailing address

519 S 7TH Ave
Maywood, IL 60153-1506
Phone (708) 345-9894

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040602000619 IL Part B Supplier - Clinic/Group Practice 3678555844 Receives reassigned benefits from 1 practitioner
Practice locations: Maywood, IL

National Provider Directory

National Provider Directory

Locations

45 W 111th St
Ste B
Chicago, IL 60628
Phone (773) 370-5254

Practitioners & affiliated clinicians

Practitioners 1

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": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1851328546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 S 7TH AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601531506",
            "telephone_number": "708-345-9894",
            "fax_number": "708-345-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W 111TH ST",
            "address_2": "SUITE B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284247",
            "telephone_number": "773-370-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORYBDEER LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-345-9894",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "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 Oct 25, 2007; 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.