Active NPI
J L Giacchino/S D Demorest MD Assc
- Family Medicine Physician
- Melrose Park, IL
National Provider Identifier
1285823237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- J L GIACCHINO/S D DEMOREST MD ASSC
- Practice address
- 1252 Winston Plaza
Melrose Park, IL 60160-1507 - Phone
- (708) 343-2500
- Fax
- (708) 343-9545
- NPI assigned
- Oct 16, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joseph L Giacchino Jr.
- Title
- Owner
- Phone
- (708) 343-2500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
1252 Winston Plaza
Melrose Park, IL 60160-1507
Mailing address
8383 W Belmont Ave
Suite 307
River Grove, IL 60171
Phone (708) 453-1325
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 737320 | Other | IL | MEDICARE |
| 21608664 | Other | IL | BLUE CROSS/BLUE SHIELD |
National Provider Directory
National Provider Directory- Tax ID family
- J L Giacchinos D Demorest MD Assc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Primary Care Clinic/Center
- River Grove, IL
- NPI 1235327941
Locations
8383 Belmont Ave
Ste 307
River Grove, IL 60171
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192492800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213747200000",
"number": "1285823237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8383 W BELMONT AVE",
"address_2": "SUITE 307",
"city": "RIVER GROVE",
"state": "IL",
"postal_code": "60171",
"telephone_number": "708-453-1325",
"fax_number": "708-453-1401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1252 WINSTON PLAZA",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "601601507",
"telephone_number": "708-343-2500",
"fax_number": "708-343-9545"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "J L GIACCHINO/S D DEMOREST MD ASSC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-16",
"last_updated": "2008-06-18",
"status": "A",
"authorized_official_last_name": "GIACCHINO",
"authorized_official_first_name": "JOSEPH",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "708-343-2500",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "737320",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "21608664",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melrose Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.