Organization Active NPI

Leo Taiberg, MD SC

  • Critical Care Medicine (Internal Medicine) Physician
  • Chicago, IL
National Provider Identifier
1942309547
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
LEO TAIBERG, MD SC
Practice address
2525 S Michigan Ave
Chicago, IL 60616-2333
Phone
(630) 789-2550
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Authorized official

Name
Leo Taiberg, MD
Title
Sole Proprietor
Phone
(630) 789-2550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0200X IL Primary

Addresses

Primary practice location

2525 S Michigan Ave
Chicago, IL 60616-2333

Mailing address

777 Oakmont LN
Suite 1600
Westmont, IL 60559-5511
Phone (630) 789-2550

Other identifiers 2

IdentifierTypeStateIssuer
01634713OtherILBCBS PROVIDER ID
DC3900OtherILRAIL ROAD MEDICARE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1942309547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 OAKMONT LN",
            "address_2": "SUITE 1600",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595511",
            "telephone_number": "630-789-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162333",
            "telephone_number": "630-789-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEO TAIBERG, MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "TAIBERG",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "630-789-2550",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "01634713",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "DC3900",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.