Individual provider Active NPI

Paulette C Trum, M.D

  • Psychiatry Physician
  • Joliet, IL
National Provider Identifier
1467473462
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036072698 Issued in IL
Practice address
210 N Hammes Ave
Suite 205
Joliet, IL 60435-8139
Phone
(815) 729-7790
Fax
(815) 725-8144
NPI assigned
Jul 22, 2006
Last updated
Sep 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036072698 IL Primary

Addresses

Primary practice location

210 N Hammes Ave
Suite 205
Joliet, IL 60435-8139

Mailing address

210 N Hammes Ave
Suite 205
Joliet, IL 60435-8139
Phone (815) 729-7790

Other identifiers 1

IdentifierTypeStateIssuer
1760647226OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080520000676 IL Practitioner - Psychiatry 4789753518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036072698ILMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1467473462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N HAMMES AVE",
            "address_2": "SUITE 205",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358139",
            "telephone_number": "815-729-7790",
            "fax_number": "815-725-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N HAMMES AVE",
            "address_2": "SUITE 205",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358139",
            "telephone_number": "815-729-7790",
            "fax_number": "815-725-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUM",
        "first_name": "PAULETTE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036072698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760647226",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.