Promedex, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

041153453 Issued in IL

Legal business name

PROMEDEX, LLC

Practice address

1185 Cobble Hill CT
Hoffman Estates, IL 60169-6913

Phone

(224) 653-9976

Fax

(224) 653-9978

NPI assigned

Jun 11, 2008

Last updated

Jun 11, 2008By 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

Pressie Manares Camba

Title

Registered Nurse

Phone

(224) 653-9976

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1548420763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 COBBLE HILL CT",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601696913",
            "telephone_number": "224-653-9976",
            "fax_number": "224-653-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 COBBLE HILL CT",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601696913",
            "telephone_number": "224-653-9976",
            "fax_number": "224-653-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDEX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "CAMBA",
        "authorized_official_first_name": "PRESSIE",
        "authorized_official_middle_name": "MANARES",
        "authorized_official_title_or_position": "REGISTERED NURSE",
        "authorized_official_telephone_number": "224-653-9976"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "041153453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.