Mpac SMH of California Aco PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

MPAC SMH OF CALIFORNIA ACO PC

Practice address

3000 N Halsted St Ste 803
Chicago, IL 60657-6185

Phone

(888) 705-8722

Fax

(888) 705-8722

NPI assigned

Sep 21, 2023

Last updated

Nov 26, 2024By 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

Sean Cannone, DO

Title

Owner / Cmo

Phone

(888) 660-4425

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1568240315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80693",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917168415",
            "telephone_number": "888-705-8722",
            "fax_number": "888-705-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST STE 803",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576185",
            "telephone_number": "888-705-8722",
            "fax_number": "888-705-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MPAC SMH OF CALIFORNIA ACO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-21",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "CANNONE",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER / CMO",
        "authorized_official_telephone_number": "888-660-4425",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mpi, Inc.

• Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.