NPIMap

Organization Active NPI

Presence Saint Joseph Hospital-Elgin

Doing business as Heart Failure Clinic

  • Nurse Practitioner
  • Elgin, IL
National Provider Identifier
1104262377
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209008175 Issued in IL
Legal business name
PRESENCE SAINT JOSEPH HOSPITAL-ELGIN
Doing business as
Heart Failure Clinic
Practice address
77 N Airlite St
Elgin, IL 60123-4912
Phone
(847) 695-3200
NPI assigned
May 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Authorized official

Name
Melvonne Jones
Title
Credentialing Manager
Phone
(630) 914-2417

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X 209008175 IL Primary
Adult Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LA2200X 209-006950 IL

Addresses

Primary practice location

77 N Airlite St
Elgin, IL 60123-4912

Mailing address

1000 Remington Blvd
Ste 100
Bolingbrook, IL 60440-5114
Phone (630) 914-2417

Other names 1

  • Heart Failure Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mercy Ctr Health Phys E16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1104262377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 REMINGTON BLVD",
            "address_2": "STE 100",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405114",
            "telephone_number": "630-914-2417",
            "fax_number": "630-914-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N AIRLITE ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234912",
            "telephone_number": "847-695-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE SAINT JOSEPH HOSPITAL-ELGIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MELVONNE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "630-914-2417"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209008175",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209-006950",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heart Failure Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.