NPIMap

Organization Active NPI

St James Hospital United States Catholic Conference

Doing business as St James Franciscan Medical Pavilion

  • Family Medicine Physician
  • Olympia Fields, IL
National Provider Identifier
1124322680
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST JAMES HOSPITAL UNITED STATES CATHOLIC CONFERENCE
Doing business as
St James Franciscan Medical Pavilion
Practice address
3700 W 203Rd St
Olympia Fields, IL 60461-1180
Phone
(708) 709-6295
NPI assigned
Dec 27, 2010
Last updated
Dec 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Authorized official

Name
Mr. Thomas Senesac
Title
Treasurer
Phone
(708) 756-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

3700 W 203Rd St
Olympia Fields, IL 60461-1180

Mailing address

1040 Sierra Dr
Suite 400
Greenwood, IN 46143-7240
Phone (317) 528-4250

Other names 1

  • St James Franciscan Medical Pavilion Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1124322680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SIERRA DR",
            "address_2": "SUITE 400",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437240",
            "telephone_number": "317-528-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W 203RD ST",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611180",
            "telephone_number": "708-709-6295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JAMES HOSPITAL UNITED STATES CATHOLIC CONFERENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-27",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "SENESAC",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "708-756-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St James Franciscan Medical Pavilion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.