Active NPI
Kavork Edward Hagopian, PT
- General Acute Care Hospital
- Libertyville, IL
National Provider Identifier
1194073882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 225100000X
- Practice address
- 801 S Milwaukee Ave
Libertyville, IL 60048-3204 - Phone
- (847) 990-2147
- NPI assigned
- Aug 28, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 225100000X | IL | Primary |
Addresses
Primary practice location
801 S Milwaukee Ave
Libertyville, IL 60048-3204
Mailing address
801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 990-2147
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 225100000X | IL | MD | General Acute Care Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346112000000",
"number": "1194073882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 S MILWAUKEE AVE",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600483204",
"telephone_number": "847-990-2147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 S MILWAUKEE AVE",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600483204",
"telephone_number": "847-990-2147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGOPIAN",
"first_name": "KAVORK",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-28",
"last_updated": "2012-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "IL",
"license": "225100000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Libertyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.