NPIMap

Organization Active NPI

Infinite Medical Center LLC

  • Family Medicine Physician
  • Glen Carbon, IL
National Provider Identifier
1013470905
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INFINITE MEDICAL CENTER LLC
Practice address
220 Evergreen Drive
Glen Carbon, IL 62034-6203
Phone
(618) 655-0333
NPI assigned
Apr 9, 2019
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Ryan Cleland, DCNPI 1508051830
Title
Owner
Phone
(618) 980-3150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

220 Evergreen Drive
Glen Carbon, IL 62034-6203

Mailing address

28 Meadow Rue Dr
Edwardsville, IL 62025-3141
Phone (618) 980-3150

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1013470905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 MEADOW RUE DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253141",
            "telephone_number": "618-980-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 EVERGREEN DRIVE",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620346203",
            "telephone_number": "618-655-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITE MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "CLELAND",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-980-3150",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.