WEST SUBURBAN MEDICAL CENTER (NPI# 1649499096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649499096 |
| Entity Type | Organization |
| Organization Name | WEST SUBURBAN MEDICAL CENTER |
| Other Organization Name | WEST SUBURBAN HEALTH CARE PHYSICIANS SVCS |
| Practice Address |
52256 Eagle Way W Suburban Health Care Physicians Svcs Chicago IL 60678-1522 |
| Mailing Address |
7411 Lake St Suite L140 River Forest IL 60305-1876 |
| Practice Telephone | 7087637877 |
| Practice Fax Number | 7087635550 |
| Mailing Telephone | 7087637877 |
| Mailing Fax Number | 7087635550 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2008-06-18 |
| Authorized Official Name | SUSAN PFISTER (SYSTEM DIRECTOR PATIENT FINANCIAL S) |
| Authorized Official Telephone | 8478133716 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | IL | Allopathic & Osteopathic Physicians | |
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
IL | Allopathic & Osteopathic Physicians | |
| N | 363L00000X | Nurse Practitioner | IL | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 207Q00000X | Family Medicine | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS GROUP NUMBER | 21623162 | 01 |
| Other Name | Type Code |
|---|---|
| West Suburban Health Care Physicians SVCS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073742748 | West Suburban Medical Center | Internal Medicine | 3245 S. Grove Avenue, Ste 105 & 106, Berwyn, IL 60402 | 2009-07-02 |
| 1811167430 | West Suburban Medical Center | Internal Medicine | 1025 Pleasant Pl, Annex, Oak Park, IL 60302-3172 | 2008-03-11 |
| 1194995993 | West Suburban Medical Center | Internal Medicine | 114 S Humphrey Ave, Units #101 & #102, Oak Park, IL 60302-2793 | 2008-03-07 |
| 1598987091 | West Suburban Medical Center | Emergency Medicine | 35001 Eagle Way, Chicago, IL 60678-1350 | 2007-05-03 |
| 1841419207 | West Suburban Medical Center | Obstetrics & Gynecology | Box 4063 Women's Health Center, Carol Stream, IL 60122-0001 | 2007-04-24 |
| 1518097567 | West Suburban Medical Center | Radiology | 420 William St, Bone Density At Fpc, River Forest, IL 60305-1920 | 2007-03-07 |
| 1275558983 | West Suburban Medical Center | Obstetrics & Gynecology | 7339 Madison St, Womens Health Center, Forest Park, IL 60130-1543 | 2006-07-13 |
| 1700801966 | West Suburban Medical Center | Family Medicine | 1 Erie Court, Ste 6160, Oak Park, IL 60302 | 2006-07-12 |
| 1225073984 | West Suburban Medical Center | Radiology | 7420 Central Avenue, River Forest, IL 60305-1800 | 2006-06-18 |
| 1447563994 | West Suburban Medical Center | Internal Medicine | 9855 W Roosevelt Rd, Westchester, IL 60154-2758 | 2010-07-26 |
| Street Address |
52256 EAGLE WAY W SUBURBAN HEALTH CARE PHYSICIANS SVCS |
| City | CHICAGO |
| State | IL |
| Zip Code | 60678-1522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255570263 | Bryan Christopher Swanson | Emergency Medicine | 35491 Eagle Way, Chicago, IL 60678-0001 | 2009-02-13 |
| 1598987091 | West Suburban Medical Center | Emergency Medicine | 35001 Eagle Way, Chicago, IL 60678-1350 | 2007-05-03 |
| 1265855209 | Mariam M Eldeib I | Social Worker | 38205 Eagle Way, Chicago, IL 60678-1382 | 2014-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083414 | Cedomir Micic | Pharmacist | 1111 W 14th Pl Unit 126, Chicago, IL 60608-2796 | 2020-11-07 |
| 1780285429 | Lily Heine | Speech-Language Pathologist | 1425 W Albion Ave Apt 3, Chicago, IL 60626-5022 | 2020-11-07 |
| 1295336022 | Web Healing Collective Pllc | Social Worker | 6207 N Springfield Ave, Chicago, IL 60659-1015 | 2020-11-06 |
| 1609477579 | Shantrell Patrice Sutton | Counselor | 5042 W Erie St, Chicago, IL 60644-1604 | 2020-11-05 |
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1730780602 | Saba Aqel | Counselor | 107 W Van Buren St Ste 215, Chicago, IL 60605-1054 | 2020-11-05 |
| 1558962720 | Christine Nance | Registered Nurse | 125 W 109th St, Chicago, IL 60628-3432 | 2020-11-04 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1598366726 | Frankie O'brien | Dietitian, Registered | 2551 N Clark St Ste 400, Chicago, IL 60614-7725 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| Find all providers in CHICAGO | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1124645700 | Timothy Alan Williams Jr. | Family Medicine | 1625 E 75th St Fl 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1194340026 | Kaysha Lynne Ribao | Family Medicine | 2116 S Springfield Ave, Chicago, IL 60623-2465 | 2020-06-16 |
| 1932724341 | Toni Kurian | Family Medicine | 1550 S Indiana Ave Apt 407, Chicago, IL 60605-4822 | 2020-06-11 |
| 1528689486 | Thurman J Robertson | Family Medicine | 1950 W. Polk Street, 7th Floor, Chicago, IL 60612-3714 | 2020-05-01 |
| 1629697297 | Lyndsey Danielle Johnson | Family Medicine | 2804 W Walton St, Chicago, IL 60622-4450 | 2020-04-13 |
| 1730708884 | Iruoma Genevieve Nwangwu | Family Medicine | 1950 W Polk Street, Chicago, IL 60612-3714 | 2020-04-09 |
| Find all providers in CHICAGO | ||||
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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.