NPIMap

Organization Active NPI

Mens Health Chicago LLC

  • Adult Health Nurse Practitioner
  • Bartlett, IL
National Provider Identifier
1104111848
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP3397 Issued in AZ
Legal business name
MENS HEALTH CHICAGO LLC
Practice address
1396 Newcastle CT
Bartlett, IL 60103-2989
Phone
(480) 229-2013
NPI assigned
Jun 10, 2011
Last updated
Jun 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Authorized official

Name
Jr Wade
Title
Member
Phone
(480) 229-1986

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP3397 AZ Primary

Addresses

Primary practice location

1396 Newcastle CT
Bartlett, IL 60103-2989

Mailing address

12878 N 119TH St
Scottsdale, AZ 85259-2736

National Provider Directory

National Provider Directory

Locations

1325 Remington Rd
Ste X
Schaumburg, IL 60173
Phone (630) 237-4500

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307664000000",
    "number": "1104111848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12878 N 119TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852592736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1396 NEWCASTLE CT",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601032989",
            "telephone_number": "480-229-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENS HEALTH CHICAGO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-06-10",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "JR",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "480-229-1986"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP3397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.