Provider Demographics
NPI:1750550703
Name:NORTH SUBURBAN PHYSICIANS GROUP, LTD
Entity type:Organization
Organization Name:NORTH SUBURBAN PHYSICIANS GROUP, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE/BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SARAFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-699-8888
Mailing Address - Street 1:241 GOLF MILL CTR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1224
Mailing Address - Country:US
Mailing Address - Phone:847-699-8888
Mailing Address - Fax:847-699-8830
Practice Address - Street 1:241 GOLF MILL CTR
Practice Address - Street 2:SUITE 600
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1224
Practice Address - Country:US
Practice Address - Phone:847-699-8888
Practice Address - Fax:847-699-8830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008965111N00000X
IL038008113111N00000X
IL036100991174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty