Provider Demographics
NPI:1992853105
Name:NORTH SUBURBAN MEDICAL S.C.
Entity Type:Organization
Organization Name:NORTH SUBURBAN MEDICAL S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RHEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-263-0480
Mailing Address - Street 1:1800 NATIONS DR STE 101
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-9169
Mailing Address - Country:US
Mailing Address - Phone:847-263-0480
Mailing Address - Fax:847-263-0590
Practice Address - Street 1:1800 NATIONS DR STE 101
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-9169
Practice Address - Country:US
Practice Address - Phone:847-263-0480
Practice Address - Fax:847-263-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04930341OtherBCBS
IL209948Medicare ID - Type Unspecified