Edm Consultant Services LTD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

36091925 Issued in IL

Legal business name

EDM CONSULTANT SERVICES LTD

Practice address

675 W North Ave
Ste 104
Melrose Park, IL 60160

Phone

(708) 681-7695

Fax

(708) 345-7112

NPI assigned

Jun 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Rim Joubran, MDNPI 1164489241

Title

MD

Phone

(708) 681-7695

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Rim Joubran Other name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rim Joubran, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Melrose Park, IL
  • NPI 1164489241
  Medicare reassignment Care Compare group NPD Authorized official
• Nicole Decoudres, PA-C

  • Physician Assistant
  • Melrose Park, IL
  • NPI 1861745952
  Medicare reassignment Care Compare group
• Cindy-Lu Zwart, R.D., L.D.N., C.D.E.

  • Registered Dietitian
  • Melrose Park, IL
  • NPI 1457367500
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1497792840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "STE 104",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "60160",
            "telephone_number": "708-681-7695",
            "fax_number": "708-345-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "STE 104",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "60160",
            "telephone_number": "708-681-7695",
            "fax_number": "708-345-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDM CONSULTANT SERVICES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "JOUBRAN",
        "authorized_official_first_name": "RIM",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "708-681-7695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36091925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3362078002",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091925",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "21623287",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rim Joubran",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jude Dumfeh, MD
• Dupage Medical Group, LTD.
• Jessica Lynn Dye, PA-C
• Matthew Earle, B.S.
• Keri Edgeworth, MSW
• Faramarz Eghrari, M.D.
• Thomas Kenneth Ehni, M.D.
• Matthew P Ehrhardt, PHARMD
• Laura A Eichstaedt, LCSW
• Pamela Ann Ekegren-Piechocinski

• Family Medicine Physician in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.