Illiana Home Physician Services Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036087374 Issued in IL

Legal business name

ILLIANA HOME PHYSICIAN SERVICES INC

Practice address

1609 Sibley Blvd
Calumet City, IL 60409-2217

Phone

(773) 359-4757

NPI assigned

Jul 31, 2015

Last updated

Feb 19, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Beckett, M.D.

Title

Manager

Phone

(773) 359-4757

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1508242629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 SIBLEY BLVD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604092217",
            "telephone_number": "773-359-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 SIBLEY BLVD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604092217",
            "telephone_number": "773-359-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLIANA HOME PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "BECKETT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-359-4757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "036087374",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036087374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087374",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary E Howard
• Tifannie Howard
• Hudson Home Care
• Latoya Hutcherson
• Theresa Ibeabuchi, NURSE PRACTITIONER
• Illiana Home Physician Services Inc
• Vincent Wing Ing, D.C.
• Injury Centers of Illinois
• Integrated Dermatology of Calumet City LLC
• Integrity Home Health Care Services, Inc

• Internal Medicine Physician in Calumet City, IL
• Providers in Calumet City, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.