TRV - Family Medicine, LTD.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036092385 Issued in IL

Legal business name

TRV - FAMILY MEDICINE, LTD.

Practice address

2740 W Foster Ave
Suite 214
Chicago, IL 60625-3500

Phone

(773) 506-2000

Fax

(773) 506-2668

NPI assigned

Aug 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Tony R. Vancauwelaert, M.D.

Title

President

Phone

(773) 506-2000

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266537600000",
    "number": "1992811178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE",
            "address_2": "SUITE 214",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253500",
            "telephone_number": "773-506-2000",
            "fax_number": "773-506-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE",
            "address_2": "SUITE 214",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253500",
            "telephone_number": "773-506-2000",
            "fax_number": "773-506-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRV - FAMILY MEDICINE, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2010-02-19",
        "status": "A",
        "authorized_official_last_name": "VANCAUWELAERT",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-506-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036092385",
            "primary": true
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "IL",
            "license": "036092385",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036092385",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; 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.