NPIMap

Individual provider Active NPI

Roy James Bardwell Jr., D.O.

  • Family Medicine Physician
  • Tinley Park, IL
National Provider Identifier
1154562080
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036124712 Issued in IL
Practice address
16650 Harlem Ave
Suite 6
Tinley Park, IL 60477-1847
Phone
(708) 802-9355
Fax
(708) 904-4504
NPI assigned
Mar 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036124712 IL Primary

Addresses

Primary practice location

16650 Harlem Ave
Suite 6
Tinley Park, IL 60477-1847

Mailing address

16650 Harlem Avenue
Suite 6
Tinley Park, IL 60477-7241
Phone (708) 802-9355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100810000723 IL Practitioner - Family PracticePractitioner - Pain Management 2769516905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Pain Management
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Campbell Health Solutions SCGroup PAC ID 4981821931, 6 clinicians

Practice addresses (Care Compare)

16650 Harlem Ave
Suite 6
Tinley Park, IL 60477-1847
Phone (630) 649-2658

20303 Crawford Ave
Suite 220
Olympia Fields, IL 60461-1173
Phone (708) 802-9355

Hospital & facility affiliations

  • Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
  • Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048
  • Franciscan Health Olympia & Chicago Heights Hospital, Olympia Fields, IL, CCN 140172
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Health Solutions SC Family Medicine CurrentSince Jun 23, 2014 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

3235 Vollmer Rd
Ste 120
Flossmoor, IL 60422
Phone (708) 747-6900

20303 Crawford Ave
Ste 220
Olympia Flds, IL 60461
Phone (708) 748-4487

16650 Harlem Ave
Ste 6
Tinley Park, IL 60477
Phone (708) 262-6961

Interoperability endpoints

  • Direct secure messaging: rbardwell283830@direct.myadvocateaurora.org

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1154562080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16650 HARLEM AVENUE",
            "address_2": "SUITE 6",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604777241",
            "telephone_number": "708-802-9355",
            "fax_number": "708-904-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16650 HARLEM AVE",
            "address_2": "SUITE 6",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771847",
            "telephone_number": "708-802-9355",
            "fax_number": "708-904-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDWELL",
        "first_name": "ROY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-24",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036124712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.