South Side Rejuvenation LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

SOUTH SIDE REJUVENATION LLC

Practice address

17749 65TH Ave
Tinley Park, IL 60477-4370

Phone

(708) 670-2576

NPI assigned

Nov 13, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Alicia Belcher, APRNNPI 1699134247

Title

Family Nurse Practitioner

Phone

(708) 670-2576

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alicia Marie Belcher, APRN

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1699134247

  Family

  NPD Authorized official

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1386418184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17749 65TH AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774370",
            "telephone_number": "708-670-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17749 65TH AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774370",
            "telephone_number": "708-670-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SIDE REJUVENATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-12",
        "status": "A",
        "authorized_official_last_name": "BELCHER",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "708-670-2576",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Sogin Son, M.D.
• Sonus-USA, Inc.
• Michele Sorenson
• Elizabeth Rose Sotak, PT, DPT
• South Side Christian Counseling Center Group
• South Star Plus Pharmacy
• South Suburban Healthcare, Inc
• Southside Christian Counseling Center
• Southside Counseling Services, LLC
• Southtown Allergy and Asthma Care, PC

• Family Nurse Practitioner in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.