NPIMap

Organization Active NPI

Genesis Clinical Services

  • Multi-Specialty Clinic/Center
  • Wheaton, IL
National Provider Identifier
1265432140
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
GENESIS CLINICAL SERVICES
Practice address
1725 S Naperville Rd
Suite 206
Wheaton, IL 60187-8155
Phone
(630) 653-6441
Fax
(630) 653-8409
NPI assigned
Jul 21, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ralph M Orland, M.D.NPI 1265496681
Title
President
Phone
(630) 653-6441

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)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X IL Primary

Addresses

Primary practice location

1725 S Naperville Rd
Suite 206
Wheaton, IL 60187-8155

Mailing address

1725 S Naperville Rd
Suite 206
Wheaton, IL 60187-8155
Phone (630) 653-6441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040820000249 IL Part B Supplier - Clinic/Group Practice 9739153347 Receives reassigned benefits from 16 practitioners
Practice locations: Wheaton, IL

National Provider Directory

National Provider Directory

Locations

1725 S Naperville Rd
Ste 2
Wheaton, IL 60189

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265432140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 S NAPERVILLE RD",
            "address_2": "SUITE 206",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601878155",
            "telephone_number": "630-653-6441",
            "fax_number": "630-653-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 S NAPERVILLE RD",
            "address_2": "SUITE 206",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601878155",
            "telephone_number": "630-653-6441",
            "fax_number": "630-653-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS CLINICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ORLAND",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-653-6441",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, 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.
  • 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.