Dekalb Clinic Chartered

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DEKALB CLINIC CHARTERED

Practice address

165 E Plank Rd
Sycamore, IL 60178-8757

Phone

(815) 758-8671

Fax

(815) 758-1731

NPI assigned

Jul 17, 2006

Organization subpart

No

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

Authorized official

Name

William K Lee, M.D.

Title

Chairman, Board of Directors

Phone

(815) 758-8671

Specialties & licenses 3

Addresses

Locations

Practitioners 1

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

• Heriberto Menendez, M.D.

  • Pediatrics Physician
  • The Villages, FL
  • NPI 1255343398
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1518984228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 FRANKLIN ST",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601153742",
            "telephone_number": "815-758-8671",
            "fax_number": "815-758-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E PLANK RD",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601788757",
            "telephone_number": "815-758-8671",
            "fax_number": "815-758-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB CLINIC CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHAIRMAN, BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "815-758-8671",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine M Davis, MS, BCBA
• Eva De Coro, LMT
• Ricardo Manuel De Oliveira Soares, MD. FEBU
• Joseph C Dearie, MD
• Dekalb Clinic Chartered
• Dekalb Eye Consultants, LLC (Arlington Eye Physicians)
• Dekalb Hearing Services, LLC (Hauser-Ross Hearing Services)
• Dekalb Medical Clinic,Inc (Dekalb Internal Medicine)
• Dekalb Optical Shop LLC (Hauser-Ross Optical)
• Dekalb Surgical Services, LLC

• Internal Medicine Physician in Sycamore, IL
• Providers in Sycamore, 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 Oct 26, 2007; 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.