Calvin B Terrell, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

36093355 Issued in IL

Practice address

14124 Glenwood CT
Libertyville, IL 60048-1591

Phone

(847) 918-8863

Fax

(847) 918-8864

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, CA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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

• App of Illinois Ed PLLC

  • Emergency Medicine Physician
  • Waukegan, IL
  • NPI 1053860080
  Medicare reassignment NPD
• Santa Ana Physicians Group, PC

  • Emergency Medicine Physician
  • Indio, CA
  • NPI 1831592187
  Medicare reassignment NPD
• Midway Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Waukegan, IL
  • NPI 1447397526
  NPD (past)
• Emergency Medicine of Racine SC

  • Emergency Medicine Physician
  • Mount Pleasant, WI
  • NPI 1598102717
  NPD (past)

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1558347377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14124 GLENWOOD CT",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481591",
            "telephone_number": "847-918-8863",
            "fax_number": "847-918-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14124 GLENWOOD CT",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481591",
            "telephone_number": "847-918-8863",
            "fax_number": "847-918-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRELL",
        "first_name": "CALVIN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "36093355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36093355",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Telecare Pharmacy LLC
• Berenice Teliz
• Ten-Eight Counseling, PLLC
• Rosemary H Tentes, OTR/L
• Vera Terec, DDS
• Peter John Thadani, M.D.
• Jason Michael Thavenet, MOT,OTR/L,CHT
• The English Center (Libertyville Acupuncture)
• The Family Stress Clinic
• The Lambs Farm, Inc

• Emergency Medical Services (Emergency Medicine) Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.