NPIMap

Organization Active NPI

Presence Ambulatory Services

  • Urgent Care Clinic/Center
  • Park Ridge, IL
National Provider Identifier
1144588617
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PRESENCE AMBULATORY SERVICES
Doing business as
Presence Immediate Care - Park Ridge
Practice address
205 S Northwest Hwy
Suite 120
Park Ridge, IL 60068-5802
Phone
(847) 292-5200
Fax
(847) 292-5239
NPI assigned
May 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Authorized official

Name
Mrs. Melvonne Wickliffe-Jones
Title
Credentialing MGR
Phone
(630) 914-2417

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Urgent Care Clinic/Center 261QU0200X IL
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

205 S Northwest Hwy
Suite 120
Park Ridge, IL 60068-5802

Mailing address

1000 Remington Blvd
Suite 100
Bolingbrook, IL 60440-0000
Phone (630) 914-2417

Other names 1

  • Presence Immediate Care - Park Ridge 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": "1335916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363737600000",
    "number": "1144588617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 REMINGTON BLVD",
            "address_2": "SUITE 100",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604400000",
            "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": "205 S NORTHWEST HWY",
            "address_2": "SUITE 120",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600685802",
            "telephone_number": "847-292-5200",
            "fax_number": "847-292-5239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE AMBULATORY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-02",
        "last_updated": "2013-03-20",
        "status": "A",
        "authorized_official_last_name": "WICKLIFFE-JONES",
        "authorized_official_first_name": "MELVONNE",
        "authorized_official_title_or_position": "CREDENTIALING MGR",
        "authorized_official_telephone_number": "630-914-2417",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presence Immediate Care - Park Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.