Organization Active NPI

Irma Kuptel MD SC

  • Internal Medicine Physician
  • Palos Heights, IL
National Provider Identifier
1295488641
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
IRMA KUPTEL MD SC
Practice address
6400 W College Dr
Ste 600
Palos Heights, IL 60463-1900
Phone
(708) 425-4662
Fax
(708) 425-4692
NPI assigned
Jan 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Authorized official

Name
Irma Kuptel, MDNPI 1508808999
Title
President
Phone
(708) 425-4662

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

6400 W College Dr
Ste 600
Palos Heights, IL 60463-1900

Mailing address

221 Pine Tree LN
La Grange Park, IL 60526-1115
Phone (847) 334-3710

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220516001075 IL Part B Supplier - Clinic/Group Practice 0749667657 Receives reassigned benefits from 1 practitioner
Practice locations: Palos Heights, IL

National Provider Directory

National Provider Directory

Locations

6400 W College Dr
Ste 600
Palos Heights, IL 60463
Phone (708) 389-3224

Practitioners & affiliated clinicians

Practitioners 1

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": "1643155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1295488641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 PINE TREE LN",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261115",
            "telephone_number": "847-334-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 W COLLEGE DR",
            "address_2": "STE 600",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631900",
            "telephone_number": "708-425-4662",
            "fax_number": "708-425-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRMA KUPTEL MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "KUPTEL",
        "authorized_official_first_name": "IRMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-425-4662",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.