Prairie Trail Family Medicine SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

042006514 Issued in IL

Legal business name

PRAIRIE TRAIL FAMILY MEDICINE SC

Practice address

2S661 Angeline CT
Warrenville, IL 60555-1301

Phone

(630) 341-1246

Fax

(630) 489-9652

NPI assigned

Apr 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Pauline N Harding, M.D.

Title

President

Phone

(630) 341-1246

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25606/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julie Smith, D.C.

  • Chiropractor
  • Winfield, IL
  • NPI 1235214156
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1003031352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2S661 ANGELINE CT",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605551301",
            "telephone_number": "630-341-1246",
            "fax_number": "630-489-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2S661 ANGELINE CT",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605551301",
            "telephone_number": "630-341-1246",
            "fax_number": "630-489-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE TRAIL FAMILY MEDICINE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "HARDING",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-341-1246",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "042006514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine N Pontarelli, APRN, CNP
• Nicole Rose Pope, NP
• Blair Porter, PA-C
• Carlene Porter, APN.
• Gregory Louis Potempa, DDS
• Siyana Koleva Praskov, PA-C
• Brian Robert Preston
• Preventive Solutions
• Prime Urgent Care, PLLC
• Dionne L Pringle, PHARMD MBA BSC

• Family Medicine Physician in Warrenville, IL
• Providers in Warrenville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.