Organization Active NPI

Second Act LLC

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
National Provider Identifier
1679729644
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
39292878 Issued in IL
Legal business name
SECOND ACT LLC
Practice address
2768 N Lincoln Ave
Chicago, IL 60614-1321
Phone
(773) 525-2228
Fax
(773) 348-2228
NPI assigned
Aug 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Patricia J Sheehan, CMF
Title
Owner
Phone
(773) 525-2228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 39292878 IL Primary

Addresses

Primary practice location

2768 N Lincoln Ave
Chicago, IL 60614-1321

Mailing address

2768 N Lincoln Ave
Chicago, IL 60614-1321
Phone (773) 525-2228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930044177 IL DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Prosthetic Personnel 1052519303 Practice locations: Chicago, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Second Act LLC2768 N Lincoln Ave, Chicago, IL 60614-1321(773) 525-2228 Breast Prostheses and/or Accessories|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Dec 30, 2008

National Provider Directory

National Provider Directory

Locations

2768 N Lincoln Ave
Chicago, IL 60614
Phone (773) 525-2228

2924 N Lincoln Ave
Ste 1
Chicago, IL 60657
Phone (773) 525-2228

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": "1218412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1679729644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2768 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141321",
            "telephone_number": "773-525-2228",
            "fax_number": "773-348-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2768 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141321",
            "telephone_number": "773-525-2228",
            "fax_number": "773-348-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND ACT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-11",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "SHEEHAN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-525-2228",
        "authorized_official_credential": "CMF"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "39292878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.

Verify at the official NPI Registry.