NPIMap

Organization Active NPI

The Mathers Clinic LLC

  • Community/Behavioral Health Agency
  • Woodstock, IL
National Provider Identifier
1316307259
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
036054365 Issued in IL
Legal business name
THE MATHERS CLINIC LLC
Practice address
715 W Judd St
Woodstock, IL 60098-3186
Phone
(815) 444-9999
NPI assigned
Mar 4, 2016
Last updated
Jan 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Authorized official

Name
Ramesh VemuriNPI 1164508149
Title
Owner
Phone
(815) 444-9999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 036054365 IL Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

715 W Judd St
Woodstock, IL 60098-3186

Mailing address

145 S Virginia St Suite C
Crystal Lake, IL 60014

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110411000671 IL Part B Supplier - Clinic/Group Practice 7214111582 Receives reassigned benefits from 23 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Woodstock, IL; Hoffman Estates, IL; Fox Lake, IL; East Dundee, IL; Crystal Lake, IL; Chicago, IL; Elgin, IL

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

585 Tollgate Rd
Ste E
Elgin, IL 60123
Phone (847) 462-6099

6090 Strathmoor Dr
Ste 1
Rockford, IL 61107
Phone (815) 444-9999

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485388800000",
    "number": "1316307259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 S VIRGINIA ST SUITE C",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W JUDD ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983186",
            "telephone_number": "815-444-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MATHERS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-04",
        "last_updated": "2017-01-26",
        "status": "A",
        "authorized_official_last_name": "VEMURI",
        "authorized_official_first_name": "RAMESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-444-9999"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "036054365",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; 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.