NPIMap

Organization Active NPI

Covenant Holistic Healthcare Services Inc

  • Occupational Therapist
  • Bolingbrook, IL
National Provider Identifier
1477811545
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
COVENANT HOLISTIC HEALTHCARE SERVICES INC
Practice address
2388 River Hills LN
Bolingbrook, IL 60490-4937
Phone
(630) 310-2235
Fax
(630) 226-5699
NPI assigned
Apr 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Authorized official

Name
Mr. Jeffrey Scott
Title
Secretary
Phone
(630) 310-2235

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

2388 River Hills LN
Bolingbrook, IL 60490-4937

Mailing address

2388 River Hills LN
Bolingbrook, IL 60490-4937
Phone (630) 310-2235

Other identifiers 1

IdentifierTypeStateIssuer
IL3719OtherMEDICARE PTAN

National Provider Directory

National Provider Directory
Tax ID family
Covenant Holistic Healthcare Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

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": "1335398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1477811545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2388 RIVER HILLS LN",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604904937",
            "telephone_number": "630-310-2235",
            "fax_number": "630-226-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2388 RIVER HILLS LN",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604904937",
            "telephone_number": "630-310-2235",
            "fax_number": "630-226-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HOLISTIC HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "630-310-2235",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL3719",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.