Individual provider Active NPI

Josephine Minnicino, MD

  • Family Medicine Physician
  • Homewood, IL
National Provider Identifier
1528637857
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036167133 Issued in IL
Practice address
18408 Governors Hwy
Homewood, IL 60430-2911
Phone
(708) 647-0571
Fax
(708) 647-0676
NPI assigned
Jun 21, 2021
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036167133 IL Primary

Addresses

Primary practice location

18408 Governors Hwy
Homewood, IL 60430-2911

Mailing address

35318 Eagle Way
Chicago, IL 60678-1353
Phone (317) 528-4800

Other practice location 1

612 N 11th St
Quincy, IL 62301-2662
Phone (217) 224-8494

Other practice location 2

640 W Washington St
Pittsfield, IL 62363-1350
Phone (217) 285-2113

Other practice location 3

18636 Dixie Hwy
Homewood, IL 60430-3741
Phone (708) 647-0571

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231227001709 IL Practitioner - Family Practice 2365844529 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Blessingcare CorporationGroup PAC ID 2769420959, shared by 5 NPIs, 18 clinicians

Practice addresses (Care Compare)

16650 Harlem Ave
Suite 1
Tinley Park, IL 60477-1847
Phone (708) 444-1512

238 S Congress St
Rushville, IL 62681-1465
Phone (217) 322-5296

640 W Washington St
Pittsfield, IL 62363-1350
Phone (217) 223-8400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036167133ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler County Hospital District CurrentSince Mar 31, 2025 Accepting new patients
Specialty Physicians of Illinois, LLC Family Medicine CurrentSince Aug 18, 2024 Accepting new patients
Schuyler County Hospital District CurrentSince Mar 31, 2025 Accepting new patients
Memorial Hospital Association Current Accepting new patients
Blessingcare Corporation CurrentSince Nov 1, 2024 Accepting new patients
Memorial Hospital Association CurrentSince Mar 20, 2025 Accepting new patients
Blessingcare Corporation Current Accepting new patients
Memorial Hospital Association CurrentSince Mar 20, 2025 Accepting new patients
Specialty Physicians of Illinois, LLC CurrentSince Aug 11, 2024 Accepting new patients
Blessingcare Corporation Current Accepting new patients
Blessingcare Corporation CurrentSince Nov 1, 2024 Accepting new patients

Locations

1454 N County Road 2050 E
Carthage, IL 62321
Phone (217) 357-3131

35318 Eagle Way
Chicago, IL 60678

18408 Governors Hwy
Homewood, IL 60430
Phone (708) 647-0571

18636 Dixie Hwy
Homewood, IL 60430
Phone (708) 647-0571

3700 W 203rd St
Ste 301
Olympia Flds, IL 60461
Phone (708) 679-2850

640 W Washington St
Pittsfield, IL 62363
Phone (217) 285-2113

1005 Broadway St
Quincy, IL 62301

238 S Congress St
Rushville, IL 62681
Phone (217) 322-4321

1400 Otto Blvd
Sauk Village, IL 60411
Phone (708) 709-2030

16650 Harlem Ave
Ste 1
Tinley Park, IL 60477
Phone (708) 444-0484

Organizations & group practices 11

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1528637857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35318 EAGLE WAY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606781353",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18408 GOVERNORS HWY",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302911",
            "telephone_number": "708-647-0571",
            "fax_number": "708-647-0676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 N 11th St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623012662",
            "country_code": "US",
            "telephone_number": "217-224-8494",
            "fax_number": "217-224-7950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "640 W Washington St",
            "address_purpose": "LOCATION",
            "city": "Pittsfield",
            "state": "IL",
            "postal_code": "623631350",
            "country_code": "US",
            "telephone_number": "217-285-2113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18636 Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Homewood",
            "state": "IL",
            "postal_code": "604303741",
            "country_code": "US",
            "telephone_number": "708-647-0571",
            "fax_number": "708-647-0676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINNICINO",
        "first_name": "JOSEPHINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036167133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

Verify at the official NPI Registry.