Organization Active NPI

Travel Medicine Source LTD

  • Infectious Disease Physician
  • Morton Grove, IL
National Provider Identifier
1962571737
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
TRAVEL MEDICINE SOURCE LTD
Practice address
9201 Waukegan Rd
Morton Grove, IL 60053-2102
Phone
(847) 663-1566
Fax
(847) 663-1568
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Authorized official

Name
Dr. Mary Catherine Macgregor, DO
Title
Medical Director
Phone
(847) 663-1566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

9201 Waukegan Rd
Morton Grove, IL 60053-2102

Mailing address

9201 Waukegan Rd
Morton Grove, IL 60053-2102
Phone (847) 663-1566

Other identifiers 1

IdentifierTypeStateIssuer
036063587MedicaidIL

National Provider Directory

National Provider Directory

Locations

8743 W Odgen Ave
Lyons, IL 60534

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1962571737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 WAUKEGAN RD",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532102",
            "telephone_number": "847-663-1566",
            "fax_number": "847-663-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 WAUKEGAN RD",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532102",
            "telephone_number": "847-663-1566",
            "fax_number": "847-663-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVEL MEDICINE SOURCE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "MACGREGOR",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "847-663-1566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036063587",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.