NPIMap

Organization Active NPI

Cornell Abraxas Midwest

  • Community Health Clinic/Center
  • Woodridge, IL
National Provider Identifier
1669798526
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
CORNELL ABRAXAS MIDWEST
Practice address
2221 64TH St
Woodridge, IL 60517-2180
Phone
(630) 968-6477
NPI assigned
Apr 15, 2010
Last updated
Apr 15, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
CORNELL ABRAXAS GROUP, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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

Authorized official

Name
Ms. Inez C Ferrante, MBA
Title
Business Manager
Phone
(419) 747-0819

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Community Health Clinic/Center 261QC1500X NU Primary

Addresses

Primary practice location

2221 64TH St
Woodridge, IL 60517-2180

Mailing address

2221 64TH St
Woodridge, IL 60517-2180
Phone (630) 968-6477

National Provider Directory

National Provider Directory
Tax ID family
Cornell Abraxas Midwest11 organizations share this tax ID, including this one
Part of
Cornell Abraxas Midwest

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271289600000",
    "number": "1669798526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 64TH ST",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605172180",
            "telephone_number": "630-968-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 64TH ST",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605172180",
            "telephone_number": "630-968-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNELL ABRAXAS MIDWEST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORNELL ABRAXAS GROUP, INC",
        "enumeration_date": "2010-04-15",
        "last_updated": "2010-04-15",
        "status": "A",
        "authorized_official_last_name": "FERRANTE",
        "authorized_official_first_name": "INEZ",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "419-747-0819",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; 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.