Physicians Community Medical Center Hazel Crest,S.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PHYSICIANS COMMUNITY MEDICAL CENTER HAZEL CREST,S.C.

Practice address

3330 W 177TH St
Hazel Crest, IL 60429-2184

Phone

(708) 798-8112

Fax

(708) 535-6396

NPI assigned

Sep 23, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Cherise Lee-Smith

Title

Medical Billing Manager

Phone

(708) 798-8112

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1306129556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 159TH ST",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604524705",
            "telephone_number": "708-798-8112",
            "fax_number": "708-535-6396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292184",
            "telephone_number": "708-798-8112",
            "fax_number": "708-535-6396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS COMMUNITY MEDICAL CENTER HAZEL CREST,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-23",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "LEE-SMITH",
        "authorized_official_first_name": "CHERISE",
        "authorized_official_title_or_position": "MEDICAL BILLING MANAGER",
        "authorized_official_telephone_number": "708-798-8112",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacklyon Phillips
• Terry Phillips Jr., B.S
• Physical Therapy & Sports Injury Rehabilitation LTD
• Physical Therapy and Sports Injury Rehabilitation
• Physical Therapy and Sports Injury Rehabilitation, LTD
• Rachel E Piepenbrink, CSFA
• Constance Agnes Pietrzak, M.D.
• Pine Crest Health Care LLC
• Pinhas Sharon, MD LLC
• Fulton Porter III, MD

• All providers in Hazel Crest, IL
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.