NPIMap

Individual provider Active NPI

Isaac Mezo, M.D.

  • Neurology Physician
  • Channahon, IL
National Provider Identifier
1346415908
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036128413 Issued in IL
Practice address
25259 S Reed St
Channahon, IL 60410-6003
Phone
(815) 467-0555
Fax
(815) 467-9823
NPI assigned
Apr 24, 2008
Last updated
Jul 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036128413 IL Primary

Addresses

Primary practice location

25259 S Reed St
Channahon, IL 60410-6003

Mailing address

725 School St
Ste a
Morris, IL 60450-1207
Phone (815) 941-9124

Other practice location 1

1499 Lakewood Dr
Morris, IL 60450-1709
Phone (815) 942-4506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130710000241 IL Practitioner - Neurology 1850531146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

25259 S Reed St
Channahon, IL 60410-6003
Phone (815) 467-0555

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Hospital Neurology Current Accepting new patients
Morris Hospital CurrentSince Nov 1, 2015 Accepting new patients
Morris Hospital CurrentSince Nov 1, 2015 Accepting new patients
Morris Hospital Current Accepting new patients
Physician Associates of Northern New Jersey, PC Past Accepting new patients

Locations

389 E Main St
Braidwood, IL 60408
Phone (815) 458-2532

25259 S Reed St
Channahon, IL 60410
Phone (815) 467-0555

580 Sycamore St
Marseilles, IL 61341
Phone (815) 795-2122

1499 Lakewood Dr
Morris, IL 60450
Phone (815) 941-1885

1499 Lakewood Dr
Ste I
Morris, IL 60450
Phone (815) 942-4506

150 W High St
Morris, IL 60450
Phone (815) 942-2129

1802 N Division St
Ste 703
Morris, IL 60450
Phone (815) 941-8000

725 School St
Ste A
Morris, IL 60450

Interoperability endpoints

  • Direct secure messaging: isaac.mezo@direct-address.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1346415908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 SCHOOL ST",
            "address_2": "STE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501207",
            "telephone_number": "815-941-9124",
            "fax_number": "815-941-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25259 S REED ST",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604106003",
            "telephone_number": "815-467-0555",
            "fax_number": "815-467-9823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1499 Lakewood Dr",
            "address_purpose": "LOCATION",
            "city": "Morris",
            "state": "IL",
            "postal_code": "604501709",
            "country_code": "US",
            "telephone_number": "815-942-4506",
            "fax_number": "815-744-6729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEZO",
        "first_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036128413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Channahon, IL

Sources for this page

Verify at the official NPI Registry.