Theodore Voss Holroyd, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085001216 Issued in IL

Practice address

543 Orchard St
Antioch, IL 60002-3107

Phone

(847) 395-3322

Fax

(847) 395-0921

NPI assigned

Apr 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: theodoreholroyd@orchardmed.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orchard Medical Center SC

  • Family Medicine Physician
  • Antioch, IL
  • NPI 1306835491
  NPD (past)

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1467670901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 ORCHARD ST",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600023107",
            "telephone_number": "847-395-3322",
            "fax_number": "847-395-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 ORCHARD ST",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600023107",
            "telephone_number": "847-395-3322",
            "fax_number": "847-395-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLROYD",
        "first_name": "THEODORE",
        "middle_name": "VOSS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-22",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David E Herman, MD
• Shannon Marie Herman, PHARM D
• Highland Park CVS, L.L.C.
• Jimmi Devang Hingu, PTA
• Robin Ann Holmer
• Hope'S Playground Pediatric Therapy, Inc.
• Hope'S Playground Pediatric Therapy, Inc.
• Darla Jean Innis, MSW, LSW
• Amanda Renee Jackson
• Kenneth Jazdzewski, DDS

• Physician Assistant in Antioch, IL
• Providers in Antioch, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.