Active NPI
Physicals Plus, Inc
- Nurse Practitioner
- Flossmoor, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- PHYSICALS PLUS, INC
- Practice address
- 19740 Governors Hwy Ste 116
Flossmoor, IL 60422-2085 - Phone
- (708) 607-2503
- Fax
- (778) 200-3824
- NPI assigned
- Mar 5, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- April J Odom, NP
- Title
- President
- Phone
- (312) 371-7489
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
19740 Governors Hwy Ste 116
Flossmoor, IL 60422-2085
Mailing address
19740 Governors Hwy Ste 116
Flossmoor, IL 60422-2085
Phone (708) 607-2503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200219001788 | IL | Part B Supplier - Clinic/Group Practice | 2961731609 |
Receives reassigned benefits from 5 practitioners Practice locations: Flossmoor, IL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2164169 | Physicals Plus | Certificate of waiver | Mar 28, 2027 |
National Provider Directory
National Provider DirectoryLocations
575 W Exchange St
Ste 1
Crete, IL 60417
19740 Governors Hwy
Ste 116
Flossmoor, IL 60422
Phone (708) 607-2503
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Primary Care Nurse Practitioner
- Evanston, IL
- NPI 1598156705
IL, Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551744000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1653523200000",
"number": "1659839983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19740 GOVERNORS HWY STE 116",
"city": "FLOSSMOOR",
"state": "IL",
"postal_code": "604222085",
"telephone_number": "708-607-2503",
"fax_number": "778-200-3824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19740 GOVERNORS HWY STE 116",
"city": "FLOSSMOOR",
"state": "IL",
"postal_code": "604222085",
"telephone_number": "708-607-2503",
"fax_number": "778-200-3824"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHYSICALS PLUS, INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-03-05",
"last_updated": "2022-05-26",
"certification_date": "2022-05-26",
"status": "A",
"authorized_official_last_name": "ODOM",
"authorized_official_first_name": "APRIL",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "312-371-7489",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flossmoor, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.