The Palos Hills Medical Center, S.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

THE PALOS HILLS MEDICAL CENTER, S.C.

Practice address

10400 S Roberts Rd
Palos Hills, IL 60465-1972

Phone

(708) 599-3100

Fax

(708) 599-3143

NPI assigned

Jan 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. William George Revethis, M.D.

Title

Owner/Officer

Phone

(708) 599-3100

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1548445422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 S ROBERTS RD",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651972",
            "telephone_number": "708-599-3100",
            "fax_number": "708-599-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 S ROBERTS RD",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651972",
            "telephone_number": "708-599-3100",
            "fax_number": "708-599-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PALOS HILLS MEDICAL CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "REVETHIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER/OFFICER",
        "authorized_official_telephone_number": "708-599-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB1569",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1617966",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Palos Hills, IL
• Providers in Palos Hills, 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 Feb 14, 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.