Organization Active NPI

GHR Total Health and Consulting Corp

  • Family Medicine Physician
  • Oak Lawn, IL
National Provider Identifier
1417565755
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GHR TOTAL HEALTH AND CONSULTING CORP
Practice address
10522 S Cicero Ave Ste 305
Oak Lawn, IL 60453-5919
Phone
(312) 632-9776
NPI assigned
Jul 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Germaine M Henderson, NPNPI 1558714386
Title
President
Phone
(312) 632-9776

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

10522 S Cicero Ave Ste 305
Oak Lawn, IL 60453-5919

Mailing address

10522 S Cicero Ave Ste 305
Oak Lawn, IL 60453-5919
Phone (312) 632-9776

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200810000890 IL Part B Supplier - Clinic/Group Practice 9335564285 Receives reassigned benefits from 1 practitioner
Practice locations: Oak Lawn, IL

National Provider Directory

National Provider Directory

Locations

10522 S Cicero Ave
Ste 305
Oak Lawn, IL 60453
Phone (312) 632-9776

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1417565755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10522 S CICERO AVE STE 305",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535919",
            "telephone_number": "312-632-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10522 S CICERO AVE STE 305",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535919",
            "telephone_number": "312-632-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHR TOTAL HEALTH AND CONSULTING CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-22",
        "last_updated": "2024-05-08",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "GERMAINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-632-9776",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.