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NORTH SIDE NEUROLOGY SC NPI 1104087873


NPI Information

NPI: 1104087873
Provider Name: NORTH SIDE NEUROLOGY SC
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
5600 W ADDISON ST
SUITE 400
CHICAGO, IL
ZIP 60634
Phone: (847) 236-0512
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NORTH SIDE NEUROLOGY SC is a neurology psychiatry neurology in Chicago, IL. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. NORTH SIDE NEUROLOGY SC NPI is 1104087873. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5600 W ADDISON ST
SUITE 400
CHICAGO, IL
ZIP 60634-401
Phone: (847) 236-0512

The provider's authorized official is Ralph V Cabin .
The authorized official title is President and has the following contact phone number (847) 236-0512.

The enumeration date for this NPI number is 6/24/2008 and was last updated on 5/21/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurology036044468ILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========6001501MEDICAIDILLINOIS

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: 4/28/2024

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