NPIMap

Organization Active NPI

Ahs Il Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Granite City, IL
National Provider Identifier
1548041866
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
AHS IL MEDICAL GROUP LLC
Practice address
3912 Maryville Rd
Granite City, IL 62040-4179
Phone
(618) 931-1335
NPI assigned
Oct 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Mr. Jonathan Burket
Title
Chief Compliance Officer
Phone
(818) 666-0602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

3912 Maryville Rd
Granite City, IL 62040-4179

Mailing address

3912 Maryville Rd
Granite City, IL 62040-4179
Phone (618) 931-1335

Other names 1

  • Gateway Medical Group/ILSW Orthopedics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ahs Il Medical Group LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3912 Maryville Rd
Granite City, IL 62040
Phone (618) 931-1335

NPI Registry JSON

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1548041866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 MARYVILLE RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404179",
            "telephone_number": "618-931-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3912 MARYVILLE RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404179",
            "telephone_number": "618-931-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHS IL MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "BURKET",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "818-666-0602",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Medical Group/ILSW Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granite City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.