NPIMap

Organization Active NPI

Alsip Integrated Medical Center S C

  • Federally Qualified Health Center (FQHC)
  • Orland Park, IL
National Provider Identifier
1609809565
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
042617005
Legal business name
ALSIP INTEGRATED MEDICAL CENTER S C
Practice address
9721 165TH St
Ste 21
Orland Park, IL 60467-5657
Phone
(708) 388-7500
Fax
(708) 942-8102
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Authorized official

Name
Dr. Becky Arlene Boros, DC
Title
Clinic Director Owner
Phone
(708) 388-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 042617005 Primary

Addresses

Primary practice location

9721 165TH St
Ste 21
Orland Park, IL 60467-5657

Mailing address

9721 165TH St
Ste 21
Orland Park, IL 60467-5657
Phone (708) 388-7500

National Provider Directory

National Provider Directory

Locations

5414 W 127th St
Alsip, IL 60803
Phone (708) 388-7500

Practitioners & affiliated clinicians

Practitioners 5

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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418083200000",
    "number": "1609809565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9721 165TH ST",
            "address_2": "STE 21",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675657",
            "telephone_number": "708-388-7500",
            "fax_number": "708-942-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9721 165TH ST",
            "address_2": "STE 21",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675657",
            "telephone_number": "708-388-7500",
            "fax_number": "708-942-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALSIP INTEGRATED MEDICAL CENTER S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-12-09",
        "status": "A",
        "authorized_official_last_name": "BOROS",
        "authorized_official_first_name": "BECKY",
        "authorized_official_middle_name": "ARLENE",
        "authorized_official_title_or_position": "CLINIC DIRECTOR OWNER",
        "authorized_official_telephone_number": "708-388-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": "042617005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; 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.