Provider Demographics
NPI:1225256860
Name:NORTH SUBURBAN MEDICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NORTH SUBURBAN MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRACTICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-295-8500
Mailing Address - Street 1:71 WAUKEGAN ROAD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044
Mailing Address - Country:US
Mailing Address - Phone:847-295-8500
Mailing Address - Fax:
Practice Address - Street 1:71 WAUKEGAN ROAD
Practice Address - Street 2:SUITE 700
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044
Practice Address - Country:US
Practice Address - Phone:847-295-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty