Komprehensive Primary Care Sports & Musculoskeletal Medicine S.C.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

036114281 Issued in IL

Legal business name

KOMPREHENSIVE PRIMARY CARE SPORTS & MUSCULOSKELETAL MEDICINE S.C.

Practice address

2813 W 147TH St
Posen, IL 60469-1516

Phone

(708) 396-9777

Fax

(708) 396-9732

NPI assigned

Feb 12, 2010

Last updated

Feb 12, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael G Ward, MDNPI 1710953070

Title

President

Phone

(312) 420-3445

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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.

• Michael G. Ward, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Hoffman Estates, IL
  • NPI 1710953070
  Medicare reassignment Authorized official
• Pamela P Kontos, NP

  • Acute Care Nurse Practitioner
  • Homewood, IL
  • NPI 1972855989
  NPD (past)

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265932800000",
    "number": "1285966440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 E 40TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606532444",
            "telephone_number": "312-420-3445",
            "fax_number": "773-536-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 W 147TH ST",
            "city": "POSEN",
            "state": "IL",
            "postal_code": "604691516",
            "telephone_number": "708-396-9777",
            "fax_number": "708-396-9732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOMPREHENSIVE PRIMARY CARE SPORTS & MUSCULOSKELETAL MEDICINE S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-12",
        "last_updated": "2010-02-12",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-420-3445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036114281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Erickson, PHARM.D.
• Danielle Nicole Gilmore, M.H.S., CFY-SLP
• Zoila Gutierrez
• Heal-Thy People Family Care Center LTD
• Heal-Thy People Ministries Inc.
• Patricia Ann Lietzow
• Latanya Morris, PA-C
• N J Amin
• Posen-Robbins El SCH Dist 1435
• Teanna Shambrae Ramirez, MSW

• Sports Medicine (Family Medicine) Physician in Posen, IL
• Providers in Posen, IL by specialty
• Sports Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; 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.