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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
Address | Telephone Number | Fax Number |
---|---|---|
180 N Michigan Ave Ste 2200, Chicago, IL 606017477 | 3126407731 | 8774211846 |
Street Address |
630 DAVIS ST STE 301 |
City | EVANSTON |
State | IL |
Zip Code | 60201-4480 |
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 |
Find all providers in zip 60201 |
Taxonomy Code | 261QM2500X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Medical Specialty |
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] |
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 |
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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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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.