NPIMap

Organization Active NPI

CSR Primary Care,LLC

  • Internal Medicine Physician
  • Evanston, IL
National Provider Identifier
1922294842
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CSR PRIMARY CARE,LLC
Doing business as
CSR Primary Care, LLC
Practice address
800 Austin St
East Tower #166
Evanston, IL 60202-3439
Phone
(847) 316-2100
NPI assigned
Sep 25, 2007
Last updated
Mar 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Authorized official

Name
Dr. Mary Lang Carney, MDNPI 1295782571
Title
Officer
Phone
(847) 316-8700

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
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

800 Austin St
East Tower #166
Evanston, IL 60202-3439

Mailing address

800 Austin St
East Tower #166
Evanston, IL 60202-3439
Phone (847) 316-2100

Other identifiers 2

IdentifierTypeStateIssuer
21623388OtherILBLUE SHIELD OF ILLINOIS
579340OtherILMEDICARE

Other names 1

  • CSR Primary Care, LLC Doing business as

National Provider Directory

National Provider Directory

Locations

1800 Sherman Ave
Ste 108
Evanston, IL 60201
Phone (847) 623-3746

800 Austin St
Ste 166
Evanston, IL 60202
Phone (847) 316-8700

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": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1922294842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST",
            "address_2": "EAST TOWER #166",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023439",
            "telephone_number": "847-316-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST",
            "address_2": "EAST TOWER #166",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023439",
            "telephone_number": "847-316-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSR PRIMARY CARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "LANG CARNEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "847-316-8700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ILLINOIS",
            "identifier": "21623388",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "579340",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSR Primary Care, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.