California Devon Medical Center

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

CALIFORNIA DEVON MEDICAL CENTER

Practice address

6420 N California Ave
Chicago, IL 60645-5253

Phone

(773) 973-6100

Fax

(773) 262-4882

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Boris Gurevich, M.D.

Title

Medical Director

Phone

(773) 973-6100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1932114386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 N CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606455253",
            "telephone_number": "773-973-6100",
            "fax_number": "773-262-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 N CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606455253",
            "telephone_number": "773-973-6100",
            "fax_number": "773-262-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA DEVON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "GUREVICH",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "773-973-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Multi-Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.