North Shore Physicians Group, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

NORTH SHORE PHYSICIANS GROUP, LLC

Practice address

1625 Sheridan Rd
Wilmette, IL 60091-1824

Phone

(847) 251-1500

NPI assigned

May 3, 2006

Organization subpart

No

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

Authorized official

Name

John E Croghan, MD

Title

Authorized Official

Phone

(847) 251-1500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1952369217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SHERIDAN RD",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911824",
            "telephone_number": "847-251-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SHERIDAN RD",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911824",
            "telephone_number": "847-251-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE PHYSICIANS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "CROGHAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "847-251-1500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shari Beth Nivasch
• Leslie Deitch Noble, M.D.
• Patricia Nolan
• North Shore Physicians Group PLLC
• North Shore Physicians Group, LLC
• North Suburban Nephrologists
• Northshore Physicians Group, LLC
• Gary James Novak, M.D.
• Jaimee Lea Novak, M.S., L.C.P.C.
• Susan B. O'Connell, LCPC

• Specialist in Wilmette, IL
• Providers in Wilmette, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.