NPIMap

Organization Active NPI

Antonio Marra

  • Primary Care Clinic/Center
  • Chicago Heights, IL
National Provider Identifier
1659777530
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
036038919 Issued in IL
Legal business name
ANTONIO MARRA
Practice address
30 E 15TH St Ste 205
Chicago Heights, IL 60411-3476
Phone
(708) 755-4401
NPI assigned
Nov 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Authorized official

Name
Dr. Antonio Marra, M.D.NPI 1225435225
Title
Owner
Phone
(708) 755-4401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 036038919 IL Primary

Addresses

Primary practice location

30 E 15TH St Ste 205
Chicago Heights, IL 60411-3476

Mailing address

30 E 15TH St Ste 205
Chicago Heights, IL 60411-3476
Phone (708) 755-4401

National Provider Directory

National Provider Directory
Tax ID family
Antonio Marra2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1415145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1659777530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 15TH ST STE 205",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113476",
            "telephone_number": "708-755-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 15TH ST STE 205",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113476",
            "telephone_number": "708-755-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTONIO MARRA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-05",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "MARRA",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-755-4401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036038919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.