Individual provider Active NPI

Theodore Christ Bellos

  • Specialist
  • Morris, IL
National Provider Identifier
1013054949
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
1300 Dresden Dr
Morris, IL 60450-2476
Phone
(815) 942-5200
Fax
(815) 942-5330
NPI assigned
Jan 31, 2007
Last updated
Feb 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Primary

Addresses

Primary practice location

1300 Dresden Dr
Morris, IL 60450-2476

Mailing address

1300 Dresden Dr
Morris, IL 60450-2476
Phone (815) 942-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
181000128ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Medical Care LTD Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1013054949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 DRESDEN DR",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604502476",
            "telephone_number": "815-942-5200",
            "fax_number": "815-942-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 DRESDEN DR",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604502476",
            "telephone_number": "815-942-5200",
            "fax_number": "815-942-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLOS",
        "first_name": "THEODORE",
        "middle_name": "CHRIST",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.