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NORTHSHORE MEDICAL PRACTICE LTD NPI 1548308364


NPI Information

NPI: 1548308364
Provider Name: NORTHSHORE MEDICAL PRACTICE LTD
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 14D0952672

Address:
92 RIVERSIDE DR
DEERFIELD, IL
ZIP 60015
Phone: (847) 573-9006
Get Directions

NORTHSHORE MEDICAL PRACTICE LTD is an internal medicine in Deerfield, IL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. NORTHSHORE MEDICAL PRACTICE LTD NPI is 1548308364. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

92 RIVERSIDE DR
DEERFIELD, IL
ZIP 60015-868
Phone: (847) 573-9006
Fax: (847) 940-0843

The provider's authorized official is Fanan Nijin Falouji .
The authorized official title is Owner and has the following contact phone number (847) 573-9006.

The CLIA number assigned to this NPI record is 14D0952672 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/2/2007 and was last updated on 3/21/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine036096519ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G83422MEDICARE UPIN
2036096519MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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