Innovative Outpatient Medical Systems

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

INNOVATIVE OUTPATIENT MEDICAL SYSTEMS

Practice address

18425 West Creek Drive
Suite G
Tinley Park, IL 60477-6767

Phone

(708) 532-1337

Fax

(708) 532-1899

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Philip Dejong

Title

Vice President

Phone

(708) 532-1337

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Innovative Care Therapy Center Doing business as

Locations

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487747556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18425 WEST CREEK DRIVE",
            "address_2": "SUITE G",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776767",
            "telephone_number": "708-532-1337",
            "fax_number": "708-532-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18425 WEST CREEK DRIVE",
            "address_2": "SUITE G",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776767",
            "telephone_number": "708-532-1337",
            "fax_number": "708-532-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE OUTPATIENT MEDICAL SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEJONG",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "708-532-1337"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9932192",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Care Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Comprehensive Outpatient Rehabilitation Facility (CORF) in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.