Organization Active NPI

Golf Mill Family Clinic

  • General Practice Physician
  • Niles, IL
National Provider Identifier
1891954707
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036088851 Issued in IL
Legal business name
GOLF MILL FAMILY CLINIC
Practice address
8937 W Golf Rd
Niles, IL 60714-5812
Phone
(847) 975-9711
NPI assigned
Jun 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Authorized official

Name
Bella Zarubinsky, MD
Title
Owner
Phone
(847) 375-9711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 036088851 IL Primary

Addresses

Primary practice location

8937 W Golf Rd
Niles, IL 60714-5812

Mailing address

8937 W Golf Rd
Niles, IL 60714-5812
Phone (847) 975-9711

Other identifiers 1

IdentifierTypeStateIssuer
036088851MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295308800000",
    "number": "1891954707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8937 W GOLF RD",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607145812",
            "telephone_number": "847-975-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8937 W GOLF RD",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607145812",
            "telephone_number": "847-975-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLF MILL FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2011-01-18",
        "status": "A",
        "authorized_official_last_name": "ZARUBINSKY",
        "authorized_official_first_name": "BELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-375-9711",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "036088851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088851",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; 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.