NPIMap

Organization Active NPI

Prime Care LTC Consulting Inc

  • Internal Medicine Physician
  • Northlake, IL
National Provider Identifier
1487075073
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRIME CARE LTC CONSULTING INC
Practice address
401 W Lake St
Northlake, IL 60164-2436
Phone
(708) 409-2318
NPI assigned
Dec 26, 2013
Last updated
Dec 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2013

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

Authorized official

Name
Dr. John Robert Haebich, M.D.
Title
Ceo
Phone
(708) 409-2318

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

401 W Lake St
Northlake, IL 60164-2436

Mailing address

401 W Lake St
Northlake, IL 60164-2436

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1388016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388016000000",
    "number": "1487075073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W LAKE ST",
            "city": "NORTHLAKE",
            "state": "IL",
            "postal_code": "601642436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W LAKE ST",
            "city": "NORTHLAKE",
            "state": "IL",
            "postal_code": "601642436",
            "telephone_number": "708-409-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE LTC CONSULTING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-26",
        "last_updated": "2013-12-26",
        "status": "A",
        "authorized_official_last_name": "HAEBICH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-409-2318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northlake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; 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.