Prevention Specialist ,LTD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PREVENTION SPECIALIST ,LTD

Practice address

565 Lakeview Pkwy
Vernon Hills, IL 60061-1857

Phone

(847) 793-9800

Fax

(847) 793-9802

NPI assigned

Mar 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mitchell R Weisberg, MD

Title

Owner

Phone

(847) 793-9800

Specialties & licenses 1

Addresses

Other names 1

• Prevention Specialist ,Ltd Former legal business name

Locations

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861526949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 LAKEVIEW PKWY",
            "address_2": "SUITE 102",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611857",
            "telephone_number": "847-793-9800",
            "fax_number": "847-793-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 LAKEVIEW PKWY",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611857",
            "telephone_number": "847-793-9800",
            "fax_number": "847-793-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTION SPECIALIST ,LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEISBERG",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-793-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prevention Specialist ,Ltd",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• 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.