NPIMap

Organization Active NPI

Elite Gynecology S.C.

  • Obstetrics & Gynecology Physician
  • Morris, IL
National Provider Identifier
1871793646
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036082983 Issued in IL
Legal business name
ELITE GYNECOLOGY S.C.
Practice address
936 W US Route 6
Morris, IL 60450-8858
Phone
(815) 942-0525
Fax
(815) 942-3501
NPI assigned
Jul 20, 2007
Last updated
Jul 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Authorized official

Name
Dr. Peter P Vienne Jr., D.O.NPI 1518962174
Title
Owner/President
Phone
(815) 942-0525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036082983 IL Primary

Addresses

Primary practice location

936 W US Route 6
Morris, IL 60450-8858

Mailing address

936 W US Route 6
Morris, IL 60450-8858
Phone (815) 942-0525

Other identifiers 1

IdentifierTypeStateIssuer
3229984OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

201 S Wabena Ave
Minooka, IL 60447
Phone (815) 467-1518

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435708800000",
    "number": "1871793646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 W US ROUTE 6",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604508858",
            "telephone_number": "815-942-0525",
            "fax_number": "815-942-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 W US ROUTE 6",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604508858",
            "telephone_number": "815-942-0525",
            "fax_number": "815-942-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE GYNECOLOGY S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2015-07-01",
        "status": "A",
        "authorized_official_last_name": "VIENNE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "815-942-0525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036082983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3229984",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.