Active NPI
Michael Deavens
- Home Health Aide
- Chicago, IL
National Provider Identifier
1023685203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 9751 S Charles St Apt 1F
Chicago, IL 60643-1250 - Phone
- (618) 353-4277
- NPI assigned
- Jun 7, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Primary |
Addresses
Primary practice location
9751 S Charles St Apt 1F
Chicago, IL 60643-1250
Mailing address
9751 S Charles St Apt 1F
Chicago, IL 60643-1250
Phone (618) 353-4277
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | mdbusinessgroupllc@gmail.com | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623024000000",
"number": "1023685203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9751 S CHARLES ST APT 1F",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606431250",
"telephone_number": "618-353-4277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9751 S CHARLES ST APT 1F",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606431250",
"telephone_number": "618-353-4277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAVENS",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-07",
"last_updated": "2021-06-07",
"certification_date": "2021-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "mdbusinessgroupllc@gmail.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "9751 S Charles St Apt 1F",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606431250",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.