North Suburban Family & Diabetic Care, LTD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036112246 Issued in IL

Legal business name

NORTH SUBURBAN FAMILY & DIABETIC CARE, LTD

Practice address

200 Milwaukee Ave
Suite 100
Buffalo Grove, IL 60089-2812

Phone

(847) 850-5377

Fax

(847) 850-5378

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Alexander Garibashvily, MD

Title

President

Phone

(847) 962-9824

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1881702942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 CHARLEMAGNE DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622109",
            "telephone_number": "847-529-4320",
            "fax_number": "847-850-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MILWAUKEE AVE",
            "address_2": "SUITE 100",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892812",
            "telephone_number": "847-850-5377",
            "fax_number": "847-850-5378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUBURBAN FAMILY & DIABETIC CARE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "GARIBASHVILY",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-962-9824",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036112246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112246",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Buffalo Grove, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.