Healthstop SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HEALTHSTOP SC

Practice address

3635 S Harlem Ave
Berwyn, IL 60402-3212

Phone

(708) 447-9402

Fax

(708) 447-3246

NPI assigned

Aug 12, 2019

Organization subpart

No

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

Authorized official

Name

Manohar Jethani, MDNPI 1366529505

Title

President

Phone

(708) 447-9402

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manohar L Jethani, MD

  • Family Medicine Physician
  • Berwyn, IL
  • NPI 1366529505
  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer L. Dunlop, APN-CNP

  • Nurse Practitioner
  • Lombard, IL
  • NPI 1912352089
  Medicare reassignment Care Compare group NPD
• Melissa Nicoletta Toulios, APN

  • Family Nurse Practitioner
  • Naperville, IL
  • NPI 1912207036
  Medicare reassignment NPD
• Ala'a Mashal, FNP

  • Family Nurse Practitioner
  • Orland Park, IL
  • NPI 1407651854
  Medicare reassignment

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565568000000",
    "number": "1225684640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 S HARLEM AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023212",
            "telephone_number": "708-447-9402",
            "fax_number": "708-447-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 S HARLEM AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023212",
            "telephone_number": "708-447-9402",
            "fax_number": "708-447-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTOP SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A",
        "authorized_official_last_name": "JETHANI",
        "authorized_official_first_name": "MANOHAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-447-9402",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hasmukh V Patel MDSC
• Yomna Hassaballa
• Damayanti S Hathiwala, MD
• Gina L Haverland, LCSW
• Health Source Pharmacy
• Healthy Hearts Doctors LLC
• Hegewisch Spine Pain Center LLC
• Kenneth Heinrich, M.D.
• Marta Herda, MD
• Josette Heredia-Carmona, LCSW

• Family Medicine Physician in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.