Blue Diamond Health Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BLUE DIAMOND HEALTH CARE LLC

Practice address

2749 W North Ave
Chicago, IL 60647-5246

Phone

(773) 292-9660

NPI assigned

Apr 5, 2010

Organization subpart

No

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

Authorized official

Name

Mr. James James Vacracos, PA-C

Title

Physician Assistant

Phone

(219) 765-3431

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James L Vacracos, PA-C

  • Physician Assistant
  • Matteson, IL
  • NPI 1659326668
  Medicare reassignment
• Ayoade O. Akere, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1538179379

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270425600000",
    "number": "1669797437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2749 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475246",
            "telephone_number": "773-292-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2749 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475246",
            "telephone_number": "773-292-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE DIAMOND HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-05",
        "last_updated": "2010-04-05",
        "status": "A",
        "authorized_official_last_name": "VACRACOS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "219-765-3431",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Marie Blount-Odum, O.D.
• Kiernan Sanderson Bloye
• Blue Bird Day LLC
• Blue Cardinal LLC
• Blue Diamond Health Care LLC
• Blue Fig LLC
• Blue Fig LLC
• Blue Island Medical Group
• Blue Island Traditional Medicine, LLC
• Blue Line Medical Inc

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.