Organization Active NPI

Premier Internists S.C.

  • Internal Medicine Physician
  • Naperville, IL
National Provider Identifier
1295953842
Registry record updated Feb 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PREMIER INTERNISTS S.C.
Practice address
620 N River Rd
Ste 102
Naperville, IL 60563-8950
Phone
(630) 355-4755
Fax
(630) 355-8838
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2015

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

Authorized official

Name
Dr. Cicily Jones, M.D.,NPI 1255396511
Title
President
Phone
(630) 355-4755

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

620 N River Rd
Ste 102
Naperville, IL 60563-8950

Mailing address

620 N River Rd
Ste 102
Naperville, IL 60563-8950
Phone (630) 355-4755

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050401000420 IL Part B Supplier - Clinic/Group Practice 6305893306 Receives reassigned benefits from 6 practitioners
Practice locations: Bolingbrook, IL; Naperville, IL

National Provider Directory

National Provider Directory

Locations

235 Remington Blvd
Ste K
Bolingbrook, IL 60440
Phone (630) 914-5153

10 Martin Ave
Ste 70
Naperville, IL 60540
Phone (630) 355-4755

620 N River Rd
Ste 102
Naperville, IL 60563
Phone (630) 355-4755

Practitioners & affiliated clinicians

Practitioners 6

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": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423785600000",
    "number": "1295953842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N RIVER RD",
            "address_2": "STE 102",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638950",
            "telephone_number": "630-355-4755",
            "fax_number": "630-355-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N RIVER RD",
            "address_2": "STE 102",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638950",
            "telephone_number": "630-355-4755",
            "fax_number": "630-355-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER INTERNISTS S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2015-02-13",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CICILY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-355-4755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "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 Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.