Provider Demographics
NPI:1922219450
Name:JAMES M NOTH M.D. , LTD
Entity type:Organization
Organization Name:JAMES M NOTH M.D. , LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:NOTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-241-0021
Mailing Address - Street 1:828 N CASS AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1394
Mailing Address - Country:US
Mailing Address - Phone:630-241-0021
Mailing Address - Fax:630-241-1882
Practice Address - Street 1:828 N CASS AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1394
Practice Address - Country:US
Practice Address - Phone:630-241-0021
Practice Address - Fax:630-241-1882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036062589174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC40112Medicare UPIN