Grant Advocate Illinois LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036119674 Issued in IL

Legal business name

GRANT ADVOCATE ILLINOIS LLC

Practice address

441 E Erie St
Suite 3712
Chicago, IL 60611-4446

Phone

(773) 816-1117

Fax

(773) 751-2250

NPI assigned

Nov 18, 2009

Last updated

Nov 18, 2009By 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

Dr. Jerisa Johnson, DO

Title

Pres

Phone

(773) 816-1117

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Jerisa Berry, D.O.

  • Emergency Medicine Physician
  • Greenacres, FL
  • NPI 1679760045
  NPD (past)

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1376871020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 E ERIE ST",
            "address_2": "SUITE 3712",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114446",
            "telephone_number": "773-816-1117",
            "fax_number": "773-751-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 E ERIE ST",
            "address_2": "SUITE 3712",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114446",
            "telephone_number": "773-816-1117",
            "fax_number": "773-751-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT ADVOCATE ILLINOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JERISA",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "773-816-1117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036119674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036119674",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Granieri, M.D.
• Lena A Granlund, D.C.
• Anna Granneman, LCSW
• Granny's Center
• Grant Advocate & Counseling SVC of Il
• Kaitlin Grant McGirr
• Akassi Grant, PTC
• Alessandra Adora Grant, LSW
• Carolyn Elizabeth Grant, AGACNP
• Carrie A Grant, PMHNP

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.