Old Orchard Obstetrics&Gynecology, S.C.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

042616899 Issued in IL

Legal business name

OLD ORCHARD OBSTETRICS&GYNECOLOGY, S.C.

Practice address

4711 Golf Rd
Suite 808
Skokie, IL 60076-1224

Phone

(847) 568-1870

Fax

(847) 568-1875

NPI assigned

Nov 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Alice Chen, M. D.

Title

President

Phone

(847) 568-1870

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Prerna Suri, MD

  • Obstetrics & Gynecology Physician
  • Skokie, IL
  • NPI 1669602959
  NPD (past)

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227139200000",
    "number": "1992950950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD",
            "address_2": "SUITE 808",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761224",
            "telephone_number": "847-568-1870",
            "fax_number": "847-568-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD",
            "address_2": "SUITE 808",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761224",
            "telephone_number": "847-568-1870",
            "fax_number": "847-568-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD ORCHARD OBSTETRICS&GYNECOLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-18",
        "last_updated": "2008-11-20",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-568-1870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "IL",
            "license": "042616899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "14D0937849",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086420",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jodi Novick Okner, LCSW
• Makanjuola Olabiyi
• Old Orchard Dental Group P.C.
• Old Orchard Endodontics
• Old Orchard Health Medical and Rehab Ctr LTD
• Old Orchard Periodontics & Implant Dentistry LTD
• Lisa Oldson, M.D.
• Margaret M Oleary, DPT
• Alisa L Oler, RDN
• Mary Oleszek, M.S., CCC-SLP

• Health Service Clinic/Center in Skokie, IL
• Providers in Skokie, IL by specialty
• Health Service Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.

Verify at the official NPI Registry.