Active NPI
Leo Taiberg, MD SC
- Critical Care Medicine (Internal Medicine) Physician
- Chicago, IL
National Provider Identifier
1942309547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01634713 | Other | IL | BCBS PROVIDER ID |
| DC3900 | Other | IL | RAIL ROAD MEDICARE |
National Provider Directory
National Provider DirectoryNPI 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.