NPIMap

Organization Active NPI

Ingalls Provider Group

  • Health Maintenance Organization
  • Hillside, IL
National Provider Identifier
1154484491
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
INGALLS PROVIDER GROUP
Practice address
4415 Harrison St
Suite 300, C-O North American Medical Management
Hillside, IL 60162-1910
Phone
(708) 432-4000
Fax
(708) 432-4077
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lynn Philipson
Title
President
Phone
(708) 915-6135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

4415 Harrison St
Suite 300, C-O North American Medical Management
Hillside, IL 60162-1910

Mailing address

4415 Harrison St
Suite 300, C-O North American Medical Management
Hillside, IL 60162-1910
Phone (708) 432-4000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154484491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 HARRISON ST",
            "address_2": "SUITE 300, C-O NORTH AMERICAN MEDICAL MANAGEMENT",
            "city": "HILLSIDE",
            "state": "IL",
            "postal_code": "601621910",
            "telephone_number": "708-432-4000",
            "fax_number": "708-432-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 HARRISON ST",
            "address_2": "SUITE 300, C-O NORTH AMERICAN MEDICAL MANAGEMENT",
            "city": "HILLSIDE",
            "state": "IL",
            "postal_code": "601621910",
            "telephone_number": "708-432-4000",
            "fax_number": "708-432-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGALLS PROVIDER GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHILIPSON",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-915-6135"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.