Individual provider Active NPI

Stanley Sims

  • Specialist
  • Tinley Park, IL
National Provider Identifier
1154460913
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
7600 183Rd St
Professional Building
Tinley Park, IL 60477-3690
Phone
(708) 614-3585
Fax
(708) 614-3546
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Primary

Addresses

Primary practice location

7600 183Rd St
Professional Building
Tinley Park, IL 60477-3690

Mailing address

7600 183Rd St
Professional Building
Tinley Park, IL 60477-3690
Phone (708) 614-3585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036-069848ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Department of Human Services Past Accepting new patients
Howe Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154460913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 183RD ST",
            "address_2": "PROFESSIONAL BUILDING",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773690",
            "telephone_number": "708-614-3585",
            "fax_number": "708-614-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 183RD ST",
            "address_2": "PROFESSIONAL BUILDING",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773690",
            "telephone_number": "708-614-3585",
            "fax_number": "708-614-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "STANLEY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.