SARA M GOTHERIDGE MD LLC


Address: 630 Davis St Ste 301, Evanston, IL 60201-4480
Phone: 3126407731

SARA M GOTHERIDGE MD LLC (NPI# 1295351062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1295351062
Entity Type Organization
Organization Name SARA M GOTHERIDGE MD LLC
Practice Address 630 Davis St Ste 301
Evanston
IL 60201-4480
Mailing Address 2412 Lawndale Ave
Evanston
IL 60201-1854
Practice Telephone 3126407731
Practice Fax Number 8774211846
Mailing Telephone 3126084996
Mailing Fax Number 8774211846
Enumeration Date 2020-06-17
Last Update Date 2020-06-17
Authorized Official Name DR. SARA MARGARET GOTHERIDGE (PRESIDENT)
Authorized Official Telephone 3126407731
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM2500X Clinic/Center
Specialization: Medical Specialty
Ambulatory Health Care Facilities

Provider Secondary Practice Location

Address Telephone Number Fax Number
180 N Michigan Ave Ste 2200, Chicago, IL 606017477 3126407731 8774211846

Office Location

Street Address 630 DAVIS ST STE 301
City EVANSTON
State IL
Zip Code 60201-4480

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1356962898 Sebastian Andres Cruz Internal Medicine Northshore University Healthsystem, Off of Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 2020-05-06
1053970442 Wade Gilman Family Medicine 1650 Ridge Ave, Ste 1304, Evanston, IL 60201 2019-06-10
1922577949 Elizabeth Wilton Therapy, LLC Counselor 2901a Central St Ste 3, Evanston, IL 60201 2018-11-20
1952887812 Sg Wellness LLC Clinic/Center 3008 Central Street, Evanston, IL 60201 2018-07-13
1689169591 Michael Kert Zijlstra Internal Medicine Northshore University Healthsystem Office of Academic, Affairs 2650 Ridge Ave, Suite 1304, Evanston, IL 60201 2018-06-25
1982199725 Elizabeth Hannah Lees Internal Medicine Northshore University Healthsystem Office of Academic A, 2650 Ridge Ave Suite 1304, Evanston, IL 60201 2018-06-25
1730674565 Ashley Elizabeth Aller Internal Medicine Northshore University Healthsystem, Office Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 2018-06-25
1669967683 Ayush N Shah Internal Medicine 2650 Ridge Ave Ste 5315, Evanston, IL 60201 2018-06-22
1811481062 Jeffrey D. Brow Internal Medicine 2650 Ridge Ave Rm 5315, Evanston, IL 60201 2018-06-20
1831687250 Michael Patrick Murphy Radiology 807 Davis St. Unit 707, Evanston, IL 60201 2018-05-01
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Taxonomy Information

Taxonomy Code 261QM2500X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Medical Specialty

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104099324 Joseph Canzona Dds Md Ltd Clinic/Center 2500 Ridge Avenue, Suite 302, Evanston, IL 60201-2477 2008-04-09
1427264456 Pandelis Banias, M.d., S.c. Clinic/Center 800 Austin St, East Tower, Suite 369, Evanston, IL 60202-3439 2007-05-15

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1407484645 Macumber Medical Ltd Clinic/Center 3114 W Irving Park Rd Ste 1w, Chicago, IL 60618-3435 2020-04-01
1477181782 Embassy Studios North Clinic/Center 6455 N Cicero Ave, Lincolnwood, IL 60712-3407 2020-03-31
1689226318 Midway Spine and Joint Pain Physicians Clinic/Center 5720 S Pulaski Rd, Chicago, IL 60629-4435 2019-07-12
1215598891 Vero Clinics Clinic/Center 1192 E Pershing Rd, Decatur, IL 62526-4753 2019-06-25
1497215933 Activate Healthcare Clinic/Center 2010 N Damen Ave Unit F, Chicago, IL 60647-3286 2019-03-21
1033699467 Healthpointe Medical Center Sc Clinic/Center 530 Fullerton Rd Ste B, Swansea, IL 62226-2970 2018-08-15
1740794882 Highland Park Cvs, L.L.C. Clinic/Center 72 Airport Plz, Bethalto, IL 62010-1774 2017-11-28
1447764014 Dr Courtney Drendel Inc Clinic/Center 515 Hamilton St # 100, Geneva, IL 60134-2138 2017-11-19
1699206599 David M Conner M.d. Clinic/Center 9 Executive Woods Ct Ste 2, Swansea, IL 62226-2016 2017-03-22
1336681568 Artemis for Women Clinic/Center 615 Woodbine Ave, Oak Park, IL 60302-1607 2016-11-04
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Competitor

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City EVANSTON
Zip Code 60201

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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