Parkside Obstetrics & Gynecology SC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

PARKSIDE OBSTETRICS & GYNECOLOGY SC

Practice address

1875 Dempster St
Suite 465
Park Ridge, IL 60068-1186

Phone

(847) 825-1100

Fax

(847) 825-0994

NPI assigned

Oct 18, 2005

Organization subpart

No

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

Authorized official

Name

Robert G. Koss, MD

Title

President

Phone

(847) 825-1100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Parkside Obstetrics Gynceology & Infertility SC Former legal business name

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1962491472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST",
            "address_2": "SUITE 465",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681186",
            "telephone_number": "847-825-1100",
            "fax_number": "847-825-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST",
            "address_2": "SUITE 465",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681186",
            "telephone_number": "847-825-1100",
            "fax_number": "847-825-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE OBSTETRICS & GYNECOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "KOSS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-825-1100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVOCATE",
            "identifier": "50108",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "01617935",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkside Obstetrics Gynceology & Infertility SC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Eunyoung Park, D.D.S.
• Hong Andy Park, M.D.
• John J Park, M.D.
• Parkside Imaging SC
• Parkside Magnetic Resonance Center, LTD
• Parkside Pediatrics, S.C.
• Adam Joshua Parnass, M.D.
• Ethan Jordan Parnass
• Jordan Rae Parnell, CNM
• Sarah Parsell

• Obstetrics & Gynecology Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.