Naperbrook Medical Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

042-007177 Issued in IL

Legal business name

NAPERBROOK MEDICAL CENTER

Practice address

686 W Boughton Rd
Bolingbrook, IL 60440-1520

Phone

(630) 378-1234

Fax

(630) 378-1155

NPI assigned

Jan 25, 2008

Last updated

Jan 25, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Meher Bala Medavaram, M.D.NPI 1376621359

Title

President

Phone

(630) 378-1234

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JDCIBA

Practitioners 2

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.

• Meher Bala Medavaram, M.D.

  • Family Medicine Physician
  • Bolingbrook, IL
  • NPI 1376621359
  Medicare reassignment Care Compare group NPD Authorized official
• Srinivas Rao Surabhi, M.D.

  • Family Medicine Physician
  • Bolingbrook, IL
  • NPI 1225126808
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201219200000",
    "number": "1184801706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 W BOUGHTON RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401520",
            "telephone_number": "630-378-1234",
            "fax_number": "630-378-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 W BOUGHTON RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401520",
            "telephone_number": "630-378-1234",
            "fax_number": "630-378-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAPERBROOK MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2008-01-25",
        "status": "A",
        "authorized_official_last_name": "MEDAVARAM",
        "authorized_official_first_name": "MEHER",
        "authorized_official_middle_name": "BALA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-378-1234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "042-007177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "09921620",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jo Ann Murphy
• Myeyedr Optometry of Illinois, LLC (MyEyeDr.)
• Mynt Dental Bolingbrook LLC
• Francis Sangyoon Nahm, DDS
• Sneha Bakulesh Naik, D.D.S
• Naperville Medical Group Corporation
• Nathan R. Fisher, D.C., S.C. (Achieve Health and Wellness)
• Natural Chiropractic Healing
• Jacqueline M Navarro
• Jerrid Neal, LPC

• Primary Care Clinic/Center in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.