Active NPI
Mike Cleary
- Durable Medical Equipment & Medical Supplies
- Naperville, IL
National Provider Identifier
1639193329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Practice address
- 811 Bakewell LN
Naperville, IL 60565-1637 - Phone
- (630) 399-6137
- Fax
- (630) 548-2357
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
811 Bakewell LN
Naperville, IL 60565-1637
Mailing address
811 Bakewell LN
Naperville, IL 60565-1637
Phone (630) 399-6137
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20214471313001 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639193329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 BAKEWELL LN",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605651637",
"telephone_number": "630-399-6137",
"fax_number": "630-548-2357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 BAKEWELL LN",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605651637",
"telephone_number": "630-399-6137",
"fax_number": "630-548-2357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEARY",
"first_name": "MIKE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20214471313001",
"state": "IL"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.