Hedges Clinic Service Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HEDGES CLINIC SERVICE CORP

Practice address

21205 Owens Rd Ste 3
Mokena, IL 60448-2023

Phone

(815) 469-2123

Fax

(815) 469-2149

NPI assigned

Nov 16, 2006

Last updated

Mar 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Frank Joseph Schibli, CMPE

Title

Administrator

Phone

(815) 469-2123

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Kishor Nathmal Jain, MD

  • Family Medicine Physician
  • Frankfort, IL
  • NPI 1568537355
  NPD
• Nabil Aref Yamout, MD

  • Surgery Physician
  • Frankfort, IL
  • NPI 1700951597
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1326111600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21205 OWENS RD STE 3",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482023",
            "telephone_number": "815-469-2123",
            "fax_number": "815-469-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21205 OWENS RD STE 3",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482023",
            "telephone_number": "815-469-2123",
            "fax_number": "815-469-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEDGES CLINIC SERVICE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "SCHIBLI",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "815-469-2123",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CMPE"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09915014",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hill-Rom Company, Inc.

• Family Medicine Physician in Mokena, IL
• Providers in Mokena, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.