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EVERGREEN FAMILY MEDICINE , NPI 1245237460

Family Medicine in EVERGREEN PARK, IL

Last Updated on : Mar 22,2018

EVERGREEN FAMILY MEDICINE , NPI 1245237460

About EVERGREEN FAMILY MEDICINE (NPI 1245237460)


EVERGREEN FAMILY MEDICINE (EVERGREEN MEDICAL, LTD.) is a Family Medicine in EVERGREEN PARK, United States .

1245237460 is NPI number of EVERGREEN FAMILY MEDICINE.

EVERGREEN FAMILY MEDICINE's primary taxonomy code based on NPI Lookup is 207Q00000X with license number 042-618475. This taxonomy code refers to Family Medicine.

EVERGREEN FAMILY MEDICINE current practice location address is 2850 W 95TH ST, EVERGREEN PARK, IL. EVERGREEN FAMILY MEDICINE can be reached out via phone at 708-423-2662 and via fax at 708-422-7264 .

You can also correspond with EVERGREEN FAMILY MEDICINE through mail at mailing address 2850 W 95TH ST, EVERGREEN PARK, IL, United States. Mailing address contact number is 708-423-2662.

The enumeration date of EVERGREEN FAMILY MEDICINE is 01-Jul-2005. The provider is registered as an Organization and the NPI record was last updated 4 years ago.

The authorized official of EVERGREEN FAMILY MEDICINE is John Elsen (President). John Elsen can be reached at 7084232662.

1245237460 NPI Information

Basic NPI information of EVERGREEN FAMILY MEDICINE (NPI 1245237460) is provided below.

Name EVERGREEN FAMILY MEDICINE
National Provider Id (NPI) 1245237460
Entity Type Organization
Practice Address 2850 W 95TH ST, SUITE 403
EVERGREEN PARK, IL, United States
Practice Telephone 708-423-2662
Practice Fax Number 708-422-7264
Mailing Address 2850 W 95TH ST , SUITE 403
EVERGREEN PARK, IL, United States
Mailing Telephone 708-423-2662
Mailing Fax Number 708-422-7264
Enumeration Date 01-Jul-2005
Last Updated Date 22-Mar-2018

EVERGREEN FAMILY MEDICINE (NPI 1245237460) Primary Taxonomy Information

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs, the license data is associated to the taxonomy code.

Primary Taxonomy Code Clasification License Number License State
Y 207Q00000X Family Medicine 042-618475 IL

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Additional Identifiers

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type/Code Identifier State Identifier Issuer
43240000 MEDICARE ID-Type Unspecified (04) IL Group ID
C45863 MEDICARE UPIN (02) IL
F54018 MEDICARE UPIN (02) IL
G91401 MEDICARE UPIN (02) IL
L18660 MEDICARE UPIN (02) IL
L63808 MEDICARE ID-Type Unspecified (04) IL Dr. Elsen ID
L63810 MEDICARE ID-Type Unspecified (04) IL Dr. Daum ID
L70347 MEDICARE ID-Type Unspecified (04) IL Dr. Hanlon ID

EVERGREEN FAMILY MEDICINE (NPI 1245237460) Office Location

Office location of EVERGREEN FAMILY MEDICINE is provided in the Google maps below.

Providers in same location

Here are a few of the other providers in the same location.

NPI Name Taxonomy Address Enumeration date
1124530456 FOUNDATIONS COUNSELING, LLC Social Worker, Clinical 9730 S WESTERN AVE STE 215,
EVERGREEN PARK, IL, United States
26-Oct-2017
1851379598 STEVEN HIRSCH WHITMAN Physical Therapist 473 W ARMY TRAIL RD, 103
BLOOMINGDALE, IL, United States
04-Jan-2006
1104361930 CRISTOBAL ROBLEDO Specialist/Technologist, Other, Surgical Assistant 2900 W 102ND ST,
EVERGREEN PARK, IL, United States
03-Jan-2017
1952458895 OMOTAYO SUNDAY OLADEJO Counselor, Professional 2853 W 98TH PL,
EVERGREEN PARK, IL, United States
04-Jan-2007
1285781856 ROCHELLE JOHNSON Social Worker, Clinical 3830 W 95TH ST,
EVERGREEN PARK, IL, United States
04-Jan-2007
1598153173 KRISTOFER DEMPSEY Pharmacist, Pharmacotherapy 9750 CRESCENT PARK CIR UNIT 513,
ORLAND PARK, IL, United States
05-Jan-2015
1639473457 ANGENETTE AYO ASAJU Occupational Therapist 9001 S RICHMOND AVE,
EVERGREEN PARK, IL, United States
08-Jan-2011
1750430351 MARILYN RITA MICHET Dentist, General Practice 9541 S PULASKI RD,
EVERGREEN PARK, IL, United States
10-Jan-2007
1851865927 KIMBERLY NORA FORST Behavior Analyst 16W361 S FRONTAGE RD STE 131,
BURR RIDGE, IL, United States
11-Jan-2019
1407907942 MALINDA ANN STEELE Social Worker, Clinical 9730 S WESTERN AVE, SUITE 627
EVERGREEN PARK, IL, United States
12-Jan-2007
1184994758 GEORGE F. HOGAN Radiology, Diagnostic Radiology 910 ALLMEN AVE,
HINSDALE, IL, United States
12-Jan-2012
1386033496 MELISSA K EWA Dentist, General Practice 9300 S CENTRAL PARK AVE,
EVERGREEN PARK, IL, United States
13-Jan-2015
1629254156 ARI FINANCIAL SERVICES Home Health 8806 S PLEASANT AVE,
CHICAGO, IL, United States
15-Jan-2008
1326190901 TARA DENISE YATES Occupational Therapist, Pediatrics 9141 S UTICA AVE,
EVERGREEN PARK, IL, United States
17-Jan-2007
1972740660 MARIA G BAYAS Nurse Practitioner, Acute Care 2800 W 95TH ST,
EVERGREEN PARK, IL, United States
16-Jan-2009
1003111469 DIANE L O'CONNOR Registered Nurse, Registered Nurse First Assistant 13309 E RED COAT DR,
LEMONT, IL, United States
17-Jan-2011
1891152815 LISA R MURPHY Nurse Practitioner, Family 1530 S STATE ST, UNIT 901
CHICAGO, IL, United States
21-Jan-2016
1366596157 PATRICIA J MILLER Counselor, Addiction (Substance Use Disorder) 14405 ASHLEY CT,
ORLAND PARK, IL, United States
22-Jan-2007
1275687071 ABDUL HAYE KHAN Surgery PO BOX 248,
WORTH, IL, United States
22-Jan-2007
1558416008 SHARON M. WILLIAMS Social Worker, Clinical 9730 S WESTERN AVE STE 627,
EVERGREEN PARK, IL, United States
24-Jan-2007

How to check whether NPI 1063496693 is valid?

The following video explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

FAQs

Whose NPI Number is 1245237460?

1245237460 is the NPI number of EVERGREEN FAMILY MEDICINE.

Where is EVERGREEN FAMILY MEDICINE located?

EVERGREEN FAMILY MEDICINE is located at 2850 W 95TH ST, EVERGREEN PARK, IL.

NPI number meaning

Field Name Field Value
NPI 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Business Mailing Address The mailing address of the provider being identified contains First line, Second Line, City name, State name, Postal code, and Country code.
Provider Business Mailing Address Telephone Number The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider Business Practice Location Address Telephone Number The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number The fax number associated with the location address of the provider being identified.
Provider Enumeration Date The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date The date that a record was last updated or changed.
Authorized Official Telephone Number The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy Taxonomy Description of the Healthcare Provider.
Provider License Number Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
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