Organization Active NPI

Community Health & Rehabilitation, SC

  • Family Medicine Physician
  • Hoffman Estates, IL
National Provider Identifier
1053404640
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-103275 Issued in IL
Legal business name
COMMUNITY HEALTH & REHABILITATION, SC
Practice address
275 W Higgins Road
Hoffman Estates, IL 60169
Phone
(847) 885-8820
Fax
(847) 885-9578
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Authorized official

Name
Anthony J PetroneNPI 1891990008
Title
Ceo
Phone
(847) 885-8820

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NX0800X 042617415 IL
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 036-103275 IL Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 1679510804 IL
Oxygen Equipment & Supplies (DME) 332BX2000X IL
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

275 W Higgins Road
Hoffman Estates, IL 60169

Mailing address

275 W Higgins Road
Hoffman Estates, IL 60169
Phone (847) 885-8820

Other identifiers 2

IdentifierTypeStateIssuer
1621687OtherILBLUE CROSS BLUE SHIELD
7761619001OtherILCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060112000686 IL Part B Supplier - Clinic/Group Practice 7214950591 Receives reassigned benefits from 4 practitioners
Practice locations: Schaumburg, IL

National Provider Directory

National Provider Directory

Locations

275 W Higgins Rd
Hoffman Estates, IL 60169
Phone (847) 885-8820

900 National Pkwy
Ste 305
Schaumburg, IL 60173
Phone (847) 885-8820

Practitioners & affiliated clinicians

Practitioners 6

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1053404640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W HIGGINS ROAD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "60169",
            "telephone_number": "847-885-8820",
            "fax_number": "847-885-9578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W HIGGINS ROAD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "60169",
            "telephone_number": "847-885-8820",
            "fax_number": "847-885-9578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH & REHABILITATION, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "PETRONE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-885-8820"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "IL",
            "license": "042617415",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-103275",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "1679510804",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1621687",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7761619001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.