Organization Active NPI

Elgin Internal Medical Associates, S.C.

  • Internal Medicine Physician
  • Elgin, IL
National Provider Identifier
1265596720
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042000063 Issued in IL
Legal business name
ELGIN INTERNAL MEDICAL ASSOCIATES, S.C.
Practice address
745 Fletcher Dr
Suite 101
Elgin, IL 60123-4747
Phone
(847) 742-3525
Fax
(847) 742-3585
NPI assigned
Dec 20, 2006
Last updated
Jun 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Authorized official

Name
Kelly Akemann, RN
Title
Practice Manager
Phone
(847) 742-3525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 042000063 IL Primary

Addresses

Primary practice location

745 Fletcher Dr
Suite 101
Elgin, IL 60123-4747

Mailing address

745 Fletcher Dr
Suite 101
Elgin, IL 60123-4747
Phone (847) 742-3525

Other identifiers 1

IdentifierTypeStateIssuer
042-000063OtherILREGISTERED MEDICAL CORPOR

National Provider Directory

National Provider Directory

Locations

745 Fletcher Dr
Ste 101
Elgin, IL 60123
Phone (847) 695-3168

860 Summit St
Ste 251
Elgin, IL 60120
Phone (847) 742-3525

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": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1265596720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 FLETCHER DR",
            "address_2": "SUITE 101",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234747",
            "telephone_number": "847-742-3525",
            "fax_number": "847-742-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 FLETCHER DR",
            "address_2": "SUITE 101",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234747",
            "telephone_number": "847-742-3525",
            "fax_number": "847-742-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELGIN INTERNAL MEDICAL ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "AKEMANN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "847-742-3525",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "042000063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED MEDICAL CORPOR",
            "identifier": "042-000063",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.