NPIMap

Organization Active NPI

Presence Hospitals PRV

Doing business as Presence Saint Joseph Medical Center - Ped/Endo Clinic

  • Pediatric Endocrinology Physician
  • Joliet, IL
National Provider Identifier
1659740033
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
Legal business name
PRESENCE HOSPITALS PRV
Doing business as
Presence Saint Joseph Medical Center - Ped/Endo Clinic
Practice address
301 Madison St
Suite 302
Joliet, IL 60435-6549
Phone
(815) 405-6285
NPI assigned
Sep 16, 2015
Last updated
Sep 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Authorized official

Name
Deborah Schimerowski
Title
Rfo
Phone
(217) 337-2740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X NU Primary

Addresses

Primary practice location

301 Madison St
Suite 302
Joliet, IL 60435-6549

Mailing address

10330 W Roosevelt Rd
Suite 200
Westchester, IL 60154-2571
Phone (815) 405-6285

Other names 1

  • PRESENCE SAINT JOSEPH MEDICAL CENTER - PED/ENDO CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Provena Covenant Med CT16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1659740033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 W ROOSEVELT RD",
            "address_2": "SUITE 200",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601542571",
            "telephone_number": "815-405-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MADISON ST",
            "address_2": "SUITE 302",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356549",
            "telephone_number": "815-405-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE HOSPITALS PRV",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "SCHIMEROWSKI",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "RFO",
        "authorized_official_telephone_number": "217-337-2740"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRESENCE SAINT JOSEPH MEDICAL CENTER - PED/ENDO CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.