Organization Active NPI

Clear River Medical PLLC

  • General Practice Physician
  • Naperville, IL
National Provider Identifier
1548721038
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CLEAR RIVER MEDICAL PLLC
Practice address
1811 Freedom Dr Ste 117
Naperville, IL 60563-5703
Phone
(630) 225-8750
Fax
(630) 225-8740
NPI assigned
Mar 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Authorized official

Name
Dr. Jeremy Darnell
Title
Owner/President
Phone
(847) 836-5202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1811 Freedom Dr Ste 117
Naperville, IL 60563-5703

Mailing address

1811 Freedom Dr Ste 117
Naperville, IL 60563-5703
Phone (630) 225-8750

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1548721038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 FREEDOM DR STE 117",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605635703",
            "telephone_number": "630-225-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 FREEDOM DR STE 117",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605635703",
            "telephone_number": "630-225-8750",
            "fax_number": "630-225-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR RIVER MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-27",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "DARNELL",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "847-836-5202",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.