Active NPI
Family Health Center Physicians, Let
- Family Medicine Physician
- South Holland, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- FAMILY HEALTH CENTER PHYSICIANS, LET
- Practice address
- 17060 S Park Ave
South Holland, IL 60473-3349 - Phone
- (708) 331-9200
- Fax
- (708) 331-5519
- NPI assigned
- Mar 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jerome T Daly, DO
- Title
- President
- Phone
- (708) 331-9200
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
17060 S Park Ave
South Holland, IL 60473-3349
Mailing address
17060 S Park Ave
South Holland, IL 60473-3349
Phone (708) 331-9200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09932131 | Other | IL | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider Directory- Tax ID family
- Family Health Center Physicians Let
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Family Medicine Physician
- Frankfort, IL
- NPI 1306963608
Locations
20325 S Graceland Ln
Frankfort, IL 60423
Phone (708) 633-8300
17060 S Park Ave
South Holland, IL 60473
Phone (708) 331-9200
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- New Lenox, IL
- NPI 1891883773
-
- Family Medicine Physician
- Frankfort, IL
- NPI 1952499832
-
- Family Medicine Physician
- Chicago, IL
- NPI 1720176605
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1194842393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17060 S PARK AVE",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "604733349",
"telephone_number": "708-331-9200",
"fax_number": "708-331-5519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17060 S PARK AVE",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "604733349",
"telephone_number": "708-331-9200",
"fax_number": "708-331-5519"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY HEALTH CENTER PHYSICIANS, LET",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "DALY",
"authorized_official_first_name": "JEROME",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "708-331-9200",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "09932131",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Holland, 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.