NPIMap

Organization Active NPI

M.D Developmental Agency LLC

  • Early Intervention Provider Agency
  • Chicago, IL
National Provider Identifier
1386181675
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
M.D DEVELOPMENTAL AGENCY LLC
Practice address
3335 S Indiana Ave
Chicago, IL 60616-3838
Phone
(708) 253-9271
NPI assigned
Jan 24, 2017
Last updated
Jan 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Authorized official

Name
Debra StewartNPI 1306152533
Title
Owner
Phone
(773) 407-7558

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NU Primary

Addresses

Primary practice location

3335 S Indiana Ave
Chicago, IL 60616-3838

Mailing address

1501 E 72ND St
Chicago, IL 60619-1511
Phone (773) 407-7558

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485216000000",
    "number": "1386181675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E 72ND ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606191511",
            "telephone_number": "773-407-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 S INDIANA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163838",
            "telephone_number": "708-253-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.D DEVELOPMENTAL AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-24",
        "last_updated": "2017-01-24",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-407-7558"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.