Organization Active NPI

Harold Jaimes, M.D., S.C.

  • Internal Medicine Physician
  • Downers Grove, IL
National Provider Identifier
1487841904
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HAROLD JAIMES, M.D., S.C.
Practice address
3800 Highland Ave
Suite 111
Downers Grove, IL 60515-1557
Phone
(630) 719-4444
NPI assigned
Sep 28, 2007
Organization subpart
Yes
Parent organization
HAROLD JAIMES, M.D.,S.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Harold Jaimes, M.D.
Title
President
Phone
(773) 395-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X IL Primary

Addresses

Primary practice location

3800 Highland Ave
Suite 111
Downers Grove, IL 60515-1557

Mailing address

3153 W Fullerton Ave
Chicago, IL 60647-2809
Phone (773) 395-4600

Other identifiers 1

IdentifierTypeStateIssuer
1605620OtherILBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041029000708 IL Part B Supplier - Clinic/Group Practice 3274595426 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL; Downers Grove, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Harold Jaimes MD PC2 organizations share this tax ID, including this one
Part of
Harold Jaimes MD PC

Other organizations with this tax ID 1

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

Locations

3153 W Fullerton Ave
Chicago, IL 60647
Phone (773) 278-6604

3800 Highland Ave
Ste 111
Downers Grove, IL 60515
Phone (630) 241-3779

Practitioners & affiliated clinicians

Practitioners 2

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": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1487841904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3153 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472809",
            "telephone_number": "773-395-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 HIGHLAND AVE",
            "address_2": "SUITE 111",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151557",
            "telephone_number": "630-719-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAROLD JAIMES, M.D., S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAROLD JAIMES, M.D.,S.C.",
        "enumeration_date": "2007-09-28",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "JAIMES",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-395-4600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1605620",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.