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1558524793 NPI number — EMERGENCY CARE PHYSICIAN SERVICES-BLUE ISLAND LTD

NPI Number: 1558524793
Health Care Provider/Practitioner: EMERGENCY CARE PHYSICIAN SERVICES-BLUE ISLAND LTD

Information about “1558524793” NPI (EMERGENCY CARE PHYSICIAN SERVICES-BLUE ISLAND LTD) exists in 1558524793 in HTML format HTML  |  1558524793 in plain Text format TXT  |  1558524793 in PDF (Portable Document Format) PDF  |  1558524793 in an XML format XML  formats.

NPI Number : 1558524793 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558524793",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "EMERGENCY CARE PHYSICIAN SERVICES-BLUE ISLAND LTD",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2000 SPRING RD",
    "SecondLineMailingAddress": "SUITE 200",
    "MailingAddressCityName": "OAK BROOK",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60523-1804",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "708-385-6685",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "12935 GREGORY ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BLUE ISLAND",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60406-2428",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "708-385-6685",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/08/2008",
    "LastUpdateDate": "06/01/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GUTERMAN",
    "AuthorizedOfficialFirstName": "SETH",
    "AuthorizedOfficialMiddleName": "J",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "708-385-6685",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207P00000X",
        "TaxonomyName": "Emergency Medicine Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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