NPIMap

Organization Active NPI

Lawrence T. Kacmar MDSC

Doing business as The Center for Primary Care and Sports Medicine

  • Durable Medical Equipment & Medical Supplies
  • Aurora, IL
National Provider Identifier
1255567558
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
036091557 Issued in IL
Legal business name
LAWRENCE T. KACMAR MDSC
Doing business as
The Center for Primary Care and Sports Medicine
Practice address
3965 75TH St
Suite 103
Aurora, IL 60504-7925
Phone
(630) 375-1625
Fax
(630) 375-1925
NPI assigned
Jun 2, 2009
Last updated
Jun 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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

Authorized official

Name
Mrs. Margaret M Cooley
Title
Office Manager
Phone
(630) 375-1625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 036091557 IL Primary

Addresses

Primary practice location

3965 75TH St
Suite 103
Aurora, IL 60504-7925

Mailing address

3965 75TH St
Suite 103
Aurora, IL 60504-7925
Phone (630) 375-1625

Other identifiers 1

IdentifierTypeStateIssuer
202522OtherILMEDICARE NUMBER

Other names 1

  • The Center for Primary Care and Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lawrence T Kacmar MD SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3965 75th St
Ste 103
Aurora, IL 60504
Phone (630) 375-1625

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": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1255567558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3965 75TH ST",
            "address_2": "SUITE 103",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047925",
            "telephone_number": "630-375-1625",
            "fax_number": "630-375-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3965 75TH ST",
            "address_2": "SUITE 103",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047925",
            "telephone_number": "630-375-1625",
            "fax_number": "630-375-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE T. KACMAR MDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "COOLEY",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "630-375-1625",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "036091557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "202522",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Center for Primary Care and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.