Active NPI
Darren Harris
- Case Manager/Care Coordinator
- Park Forest, IL
National Provider Identifier
1053814798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 5474
- Practice address
- 18 W Rocket Cir
Park Forest, IL 60466-1637 - Phone
- (708) 979-1250
- NPI assigned
- Mar 8, 2018
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 5474 | IN | Primary |
Addresses
Primary practice location
18 W Rocket Cir
Park Forest, IL 60466-1637
Mailing address
18 W Rocket Cir
Park Forest, IL 60466-1637
Phone (708) 979-1250
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5474 | IN | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520467200000",
"number": "1053814798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 W ROCKET CIR",
"city": "PARK FOREST",
"state": "IL",
"postal_code": "604661637",
"telephone_number": "708-979-1250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 W ROCKET CIR",
"city": "PARK FOREST",
"state": "IL",
"postal_code": "604661637",
"telephone_number": "708-979-1250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "DARREN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-08",
"last_updated": "2018-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "IN",
"license": "5474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.