Organization Active NPI

Adam Rubinstein MD SC

  • Internal Medicine Physician
  • Libertyville, IL
National Provider Identifier
1922152131
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ADAM RUBINSTEIN MD SC
Practice address
755 S Milwaukee Ave
Suite 210
Libertyville, IL 60048-3253
Phone
(847) 247-0300
Fax
(847) 247-8011
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Authorized official

Name
Adam M. Rubinstein, MDNPI 1871541839
Title
President
Phone
(847) 247-0300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X IL Primary

Addresses

Primary practice location

755 S Milwaukee Ave
Suite 210
Libertyville, IL 60048-3253

Mailing address

755 S Milwaukee Ave
Suite 210
Libertyville, IL 60048-3253
Phone (847) 247-0300

Other identifiers 1

IdentifierTypeStateIssuer
04923105OtherILBLUE CROSS/SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071212000499 IL Part B Supplier - Clinic/Group Practice 5597855767 Receives reassigned benefits from 1 practitioner
Practice locations: Libertyville, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1922152131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S MILWAUKEE AVE",
            "address_2": "SUITE 210",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483253",
            "telephone_number": "847-247-0300",
            "fax_number": "847-247-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S MILWAUKEE AVE",
            "address_2": "SUITE 210",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483253",
            "telephone_number": "847-247-0300",
            "fax_number": "847-247-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADAM RUBINSTEIN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "RUBINSTEIN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-247-0300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/SHIELD",
            "identifier": "04923105",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.