Charles R Harris, MD

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

Practice address

12230 Cashlenan LN
New Lenox, IL 60451-2799

Phone

(815) 463-8994

Fax

(815) 463-8946

NPI assigned

Aug 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charris@direct-address.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Foundation for Outreach Services

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1316350242
  Medicare reassignment NPD
• Edgar Delcastillo

  • Obstetrics & Gynecology Physician
  • New Lenox, IL
  • NPI 1942464789
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1508979758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12230 CASHLENAN LANE",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "60451",
            "telephone_number": "815-463-8994",
            "fax_number": "815-463-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12230 CASHLENAN LN",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604512799",
            "telephone_number": "815-463-8994",
            "fax_number": "815-463-8946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CHARLES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hallow Health and Psychiatric Services LLC
• Noura Hamoui, PHARMD
• Julie Hannigan
• Dawn Aurora Hanzie
• David Harezlak, DPT
• Julia Harris, M.S., CCC-SLP
• Rachel Joy Harris, CNM
• Joyce Hart, MS CCC-SLP
• Andrew Hatfield, NP
• Health Service Systems, Inc

• Addiction Medicine (Psychiatry & Neurology) Physician in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.