Individual provider Active NPI

Edgar Ramiro Paredes, D.T

  • Developmental Therapist
  • Melrose Park, IL
National Provider Identifier
1114101490
Registry record updated Dec 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
650 Winston Dr
Melrose Park, IL 60160-2351
Phone
(708) 410-1065
Fax
(708) 410-1065
NPI assigned
Dec 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

650 Winston Dr
Melrose Park, IL 60160-2351

Mailing address

650 Winston Dr
Melrose Park, IL 60160-2351
Phone (708) 410-1065

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": "1198368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198368000000",
    "number": "1114101490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 WINSTON DR",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601602351",
            "telephone_number": "708-410-1065",
            "fax_number": "708-410-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 WINSTON DR",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601602351",
            "telephone_number": "708-410-1065",
            "fax_number": "708-410-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAREDES",
        "first_name": "EDGAR",
        "middle_name": "RAMIRO",
        "credential": "D.T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-23",
        "last_updated": "2007-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2007; 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.