Individual provider Active NPI

Carleton Bruce Syph II

  • Home Health Aide
  • Chicago, IL
National Provider Identifier
1497574883
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
5820 S Western Ave
Chicago, IL 60636-1527
Phone
(224) 725-0765
NPI assigned
Oct 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X IL Primary

Addresses

Primary practice location

5820 S Western Ave
Chicago, IL 60636-1527

Mailing address

848 Dodge Ave # 426
Evanston, IL 60202-1506
Phone (224) 725-0765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1727913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1497574883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 DODGE AVE # 426",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021506",
            "telephone_number": "224-725-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606361527",
            "telephone_number": "224-725-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYPH",
        "first_name": "CARLETON",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.