Deerfield Medical Associates,S.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

042000410 Issued in IL

Legal business name

DEERFIELD MEDICAL ASSOCIATES,S.C.

Practice address

720 Osterman Ave
Suite 103
Deerfield, IL 60015-4471

Phone

(847) 945-3030

Fax

(847) 945-3033

NPI assigned

Jun 25, 2006

Last updated

Mar 28, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John J Stavrakos, M.D.NPI 1215966684

Title

President

Phone

(847) 945-3030

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

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.

• John J Stavrakos, M.D.

  • Internal Medicine Physician
  • Deerfield, IL
  • NPI 1215966684
  Medicare reassignment Care Compare group NPD Authorized official
• Victoria Amesbury, MD

  • Internal Medicine Physician
  • Deerfield, IL
  • NPI 1982763926
  Medicare reassignment Care Compare group NPD
• John R Andrews, M.D.

  • Colon & Rectal Surgery Physician
  • Lake Forest, IL
  • NPI 1992775340
  NPD (past)
• Stephen W Ganshirt, M.D.

  • Surgery Physician
  • Lake Forest, IL
  • NPI 1245200757
  NPD (past)
• Kim R Sobinsky, M.D.

  • Surgery Physician
  • Lake Forest, IL
  • NPI 1447220942
  NPD (past)

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648425600000",
    "number": "1881620151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 OSTERMAN AVE",
            "address_2": "SUITE 103",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154471",
            "telephone_number": "847-945-3030",
            "fax_number": "847-945-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 OSTERMAN AVE",
            "address_2": "SUITE 103",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154471",
            "telephone_number": "847-945-3030",
            "fax_number": "847-945-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEERFIELD MEDICAL ASSOCIATES,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A",
        "authorized_official_last_name": "STAVRAKOS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-945-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "042000410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daylily Counseling PLLC
• Kelly Decanio
• Nona Gayle Decastro, PHARMD
• Deer Grove Counseling PLLC
• Deerfield Dermatology Associates, LTD.
• Deerfield Orthodontics PC (Eisen Orthodontics)
• Deerfield Physical Therapy, LTD
• Deerfield SLF Limited Partnership (Deerfield Supportive Living)
• Deerfield-Bannockburn Fire Department
• Dental Professionals of Illinois, P.C. (Briarwood Park Dental Care)

• Internal Medicine Physician in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.