Active NPI
Centrad Healthcare LLC
- Durable Medical Equipment & Medical Supplies
- Naperville, IL
National Provider Identifier
1346243979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 203-000502
- Legal business name
- CENTRAD HEALTHCARE LLC
- Practice address
- 184 Shuman Blvd
Ste 130
Naperville, IL 60563-8474 - Phone
- (630) 369-5840
- Fax
- (630) 369-5436
- NPI assigned
- May 27, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. William R Korslin
- Title
- President, Ceo
- Phone
- (630) 369-5840
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 203-000502 | IL | Primary |
Addresses
Primary practice location
184 Shuman Blvd
Ste 130
Naperville, IL 60563-8474
Mailing address
184 Shuman Blvd
Ste 130
Naperville, IL 60563-8474
Phone (630) 369-5840
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18130372 | Medicaid | CO | |
| 0530980 | Medicaid | IA | |
| 221343500 | Medicaid | MN | |
| 8705402 | Medicaid | NJ | |
| MS284IL | Medicaid | AK | |
| 75 871044 01 | Medicaid | KS | |
| 02163179 | Medicaid | NY | |
| 200287520A | Medicaid | IN | |
| 520115 | Medicaid | AR | |
| 8251002 00 | Medicaid | MD | |
| 003107879 | Medicaid | CT | |
| 00876191A | Medicaid | GA | |
| 02230052 | Other | IL | BLUE CROSS BLUE SHIELD |
| 52482 | Medicaid | ND | |
| 00440846 | Medicaid | MS | |
| 009974810 | Medicaid | AL | |
| 1431532 | Medicaid | LA |
National Provider Directory
National Provider DirectoryLocations
184 Shuman Blvd
Ste 130
Naperville, IL 60563
Phone (630) 369-5840
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1323129600000",
"number": "1346243979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "184 SHUMAN BLVD",
"address_2": "STE 130",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605638474",
"telephone_number": "630-369-5840",
"fax_number": "630-369-5436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "184 SHUMAN BLVD",
"address_2": "STE 130",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605638474",
"telephone_number": "630-369-5840",
"fax_number": "630-369-5436"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTRAD HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-05-27",
"last_updated": "2011-12-06",
"status": "A",
"authorized_official_last_name": "KORSLIN",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "PRESIDENT, CEO",
"authorized_official_telephone_number": "630-369-5840",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "IL",
"license": "203-000502",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "18130372",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0530980",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "221343500",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8705402",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MS284IL",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "75 871044 01",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02163179",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200287520A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "520115",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8251002 00",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003107879",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00876191A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "02230052",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "52482",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00440846",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009974810",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1431532",
"state": "LA"
}
],
"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 Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.