Organization Active NPI

Romeoville Urgent Care PLLC

  • Internal Medicine Physician
  • Romeoville, IL
National Provider Identifier
1285496877
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ROMEOVILLE URGENT CARE PLLC
Practice address
637 N Independence Blvd
Romeoville, IL 60446-1342
Phone
(708) 620-4111
NPI assigned
Jan 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Authorized official

Name
Mr. Husam NaserNPI 1710694690
Title
Manager
Phone
(708) 870-9198

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PE0004X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Clinic/Center 261Q00000X
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

637 N Independence Blvd
Romeoville, IL 60446-1342

Mailing address

637 N Independence Blvd
Romeoville, IL 60446-1342

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240227001748 IL Part B Supplier - Clinic/Group Practice 4183069420 Receives reassigned benefits from 4 practitioners
Practice locations: Romeoville, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2304556Romeoville Urgent Care PLLC637 N Independence Blvd, Romeoville, IL 60446Certificate of waiverMay 14, 2028

National Provider Directory

National Provider Directory

Locations

637 N Independence Blvd
Romeoville, IL 60446
Phone (708) 620-4111

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1285496877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 N INDEPENDENCE BLVD",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 N INDEPENDENCE BLVD",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461342",
            "telephone_number": "708-620-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROMEOVILLE URGENT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "NASER",
        "authorized_official_first_name": "HUSAM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-870-9198",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Romeoville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.