Organization Active NPI

Sean Michael Rardin S.C.

  • Primary Care Clinic/Center
  • Aurora, IL
National Provider Identifier
1013227214
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
036114032 Issued in IL
Legal business name
SEAN MICHAEL RARDIN S.C.
Practice address
1300 N Highland Ave
Aurora, IL 60506-1451
Phone
(630) 892-7629
NPI assigned
Oct 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

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

Authorized official

Name
Carrie Rardin
Title
Office Assistant
Phone
(630) 219-3172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 036114032 IL Primary

Addresses

Primary practice location

1300 N Highland Ave
Aurora, IL 60506-1451

Mailing address

1300 N Highland Ave
Aurora, IL 60506-1451
Phone (630) 892-7629

Other names 1

  • Riverwalk Family Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

445 Aurora Ave
Naperville, IL 60540
Phone (630) 355-8844

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297382400000",
    "number": "1013227214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061451",
            "telephone_number": "630-892-7629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061451",
            "telephone_number": "630-892-7629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAN MICHAEL RARDIN S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2011-02-11",
        "status": "A",
        "authorized_official_last_name": "RARDIN",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "OFFICE ASSISTANT",
        "authorized_official_telephone_number": "630-219-3172"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036114032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverwalk Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; 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.