NPIMap

Organization Active NPI

Sally Health & Innovative Partners

Doing business as Sally Health

  • Family Medicine Physician
  • Monee, IL
National Provider Identifier
1174346415
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SALLY HEALTH & INNOVATIVE PARTNERS
Doing business as
Sally Health
Sally Health & Innovative partners
Practice address
5604 W Sutton PL Unit a
Monee, IL 60449-8131
Phone
(708) 573-3663
Fax
(866) 643-9240
NPI assigned
Nov 5, 2024
Last updated
Jun 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Authorized official

Name
Ishmael Amu
Title
Ceo
Phone
(708) 573-3663

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X NU
Clinical Medical Laboratory 291U00000X NU
Primary Care Nurse Practitioner 363LP2300X NU
Research Study Specialist 1744R1102X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

5604 W Sutton PL Unit a
Monee, IL 60449-8131

Mailing address

5410 W Main St # 371
Monee, IL 60449-8101
Phone (708) 573-3663

Other practice location 1

4801 Southwick Dr Ste 630I
Matteson, IL 60443-2254
Phone (708) 573-3663

Other names 2

  • SALLY HEALTH Doing business as
  • Sally Health & Innovative partners Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250110003113 IL Part B Supplier - Clinic/Group Practice 5496283954 Receives reassigned benefits from 7 practitioners
Practice locations: Monee, IL

National Provider Directory

National Provider Directory

Locations

4801 Southwick Dr
Ste 630I
Matteson, IL 60443
Phone (708) 573-3663

5410 W Main St
#2
Monee, IL 60449
Phone (312) 802-9646

5410 W Main St
#371
Monee, IL 60449

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1174346415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 W MAIN ST # 371",
            "city": "MONEE",
            "state": "IL",
            "postal_code": "604498101",
            "telephone_number": "708-573-3663",
            "fax_number": "866-439-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 W SUTTON PL UNIT A",
            "city": "MONEE",
            "state": "IL",
            "postal_code": "604498131",
            "telephone_number": "708-573-3663",
            "fax_number": "866-643-9240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Southwick Dr Ste 630I",
            "address_purpose": "LOCATION",
            "city": "Matteson",
            "state": "IL",
            "postal_code": "604432254",
            "country_code": "US",
            "telephone_number": "708-573-3663",
            "fax_number": "866-439-2402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SALLY HEALTH & INNOVATIVE PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "AMU",
        "authorized_official_first_name": "ISHMAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-573-3663"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SALLY HEALTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sally Health & Innovative partners",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.