NPIMap

Organization Active NPI

Ar Telemedicine of Illinois SC

  • Specialist
  • Skokie, IL
National Provider Identifier
1437693355
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
AR TELEMEDICINE OF ILLINOIS SC
Practice address
4336 Enfield Ave
Skokie, IL 60076-1806
Phone
(855) 629-8353
NPI assigned
Dec 12, 2016
Last updated
Feb 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Authorized official

Name
Tammy Timm
Title
Manager
Phone
(708) 878-2833

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Primary

Addresses

Primary practice location

4336 Enfield Ave
Skokie, IL 60076-1806

Mailing address

PO Box 663
Worth, IL 60482-0663
Phone (855) 629-8353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170221000950 IL Part B Supplier - Clinic/Group Practice 6305120213 Receives reassigned benefits from 4 practitioners
Practice locations: Skokie, IL

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486080000000",
    "number": "1437693355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 663",
            "city": "WORTH",
            "state": "IL",
            "postal_code": "604820663",
            "telephone_number": "855-629-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4336 ENFIELD AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761806",
            "telephone_number": "855-629-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AR TELEMEDICINE OF ILLINOIS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2017-02-03",
        "status": "A",
        "authorized_official_last_name": "TIMM",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-878-2833"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; 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.