NPIMap

Organization Active NPI

Midwest Respiratory, LTD.

  • Pulmonary Disease Physician
  • Joliet, IL
National Provider Identifier
1407933831
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
042-618083 Issued in IL
Legal business name
MIDWEST RESPIRATORY, LTD.
Practice address
903 129TH Infantry Dr
Suite 400
Joliet, IL 60435-3171
Phone
(815) 725-2653
Fax
(815) 744-3232
NPI assigned
Nov 1, 2006
Last updated
Jun 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Authorized official

Name
John M Walsh, M.D.NPI 1245222736
Title
President
Phone
(815) 725-2653

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 042-618083 IL Primary
Sleep Medicine (Otolaryngology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YS0012X 042-618083 IL

Addresses

Primary practice location

903 129TH Infantry Dr
Suite 400
Joliet, IL 60435-3171

Mailing address

903 129TH Infantry Dr
Suite 400
Joliet, IL 60435-3171
Phone (815) 725-2653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040903000763 IL Part B Supplier - Clinic/Group Practice 8527034263 Receives reassigned benefits from 20 practitioners
4 other NPIs on this enrollment
Practice locations: Joliet, IL; Naperville, IL; New Lenox, IL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Midwest Respiratory LTD4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1300 Copperfield Ave
Ste 4060
Joliet, IL 60432
Phone (815) 740-1301

1301 Copperfield Ave
Ste 210
Joliet, IL 60432
Phone (815) 722-3600

829 Campus Dr
Joliet, IL 60435
Phone (815) 725-2653

678 Cedar Crossings Dr
Ste 400
New Lenox, IL 60451

10660 W 143rd St
Orland Park, IL 60462
Phone (219) 838-0066

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1407933831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 129TH INFANTRY DR",
            "address_2": "SUITE 400",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353171",
            "telephone_number": "815-725-2653",
            "fax_number": "815-744-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 129TH INFANTRY DR",
            "address_2": "SUITE 400",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353171",
            "telephone_number": "815-725-2653",
            "fax_number": "815-744-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST RESPIRATORY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-725-2653",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "042-618083",
            "primary": true
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "IL",
            "license": "042-618083",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.