NPIMap

Organization Active NPI

Ultimate Medical Group LLC

  • Family Medicine Physician
  • Woodridge, IL
National Provider Identifier
1609297266
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036134622 Issued in IL
Legal business name
ULTIMATE MEDICAL GROUP LLC
Practice address
3590 Hobson Rd
Suite 301
Woodridge, IL 60517-5409
Phone
(630) 778-9000
Fax
(630) 778-9065
NPI assigned
Dec 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Authorized official

Name
Dr. Perry Cammisa
Title
Manager
Phone
(630) 817-6000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038006843 IL
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 03607713 IL
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 036134622 IL Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X 036089214 IL

Addresses

Primary practice location

3590 Hobson Rd
Suite 301
Woodridge, IL 60517-5409

Mailing address

3590 Hobson Rd
Suite 301
Woodridge, IL 60517-5409
Phone (630) 778-9000

National Provider Directory

National Provider Directory

Locations

3590 Hobson Rd
Ste 301
Woodridge, IL 60517
Phone (630) 778-9000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423180800000",
    "number": "1609297266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 HOBSON RD",
            "address_2": "SUITE 301",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605175409",
            "telephone_number": "630-778-9000",
            "fax_number": "630-778-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 HOBSON RD",
            "address_2": "SUITE 301",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605175409",
            "telephone_number": "630-778-9000",
            "fax_number": "630-778-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-30",
        "last_updated": "2015-02-06",
        "status": "A",
        "authorized_official_last_name": "CAMMISA",
        "authorized_official_first_name": "PERRY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "630-817-6000",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038006843",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "03607713",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036134622",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IL",
            "license": "036089214",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.