Active NPI
Harold Jaimes, M.D. P.C
- Internal Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- HAROLD JAIMES, M.D. P.C
- Practice address
- 3153 W Fullerton Ave
Chicago, IL 60647-2809 - Phone
- (773) 395-4600
- Fax
- (773) 395-4633
- NPI assigned
- Jun 8, 2006
- Organization subpart
- Yes
- Parent organization
- HAROLD JAIMES, M.D.,P.C.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Harold Jaimes, M.D.
- Title
- President
- Phone
- (773) 395-4600
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
3153 W Fullerton Ave
Chicago, IL 60647-2809
Mailing address
3153 W Fullerton Ave
Chicago, IL 60647-2809
Phone (773) 395-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1605620 | Other | IL | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041029000708 | IL | Part B Supplier - Clinic/Group Practice | 3274595426 |
Receives reassigned benefits from 3 practitioners 1 other NPI on this enrollment Practice locations: Chicago, IL; Downers Grove, IL |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Internal Medicine Physician
- Downers Grove, IL
- NPI 1487841904
O20041029000708
National Provider Directory
National Provider Directory- Tax ID family
- Harold Jaimes MD PC
- Part of
- Harold Jaimes MD PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Internal Medicine Physician
- Downers Grove, IL
- NPI 1487841904
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1770526279
-
- Internal Medicine Physician
- Crest Hill, IL
- NPI 1316190028
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1190937600000",
"number": "1295775146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3153 W FULLERTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606472809",
"telephone_number": "773-395-4600",
"fax_number": "773-395-4633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3153 W FULLERTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606472809",
"telephone_number": "773-395-4600",
"fax_number": "773-395-4633"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAROLD JAIMES, M.D. P.C",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HAROLD JAIMES, M.D.,P.C.",
"enumeration_date": "2006-06-08",
"last_updated": "2007-09-28",
"status": "A",
"authorized_official_last_name": "JAIMES",
"authorized_official_first_name": "HAROLD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "773-395-4600",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "1605620",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.