Illinois/Indiana Em-I Medical Services, S.C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

ILLINOIS/INDIANA EM-I MEDICAL SERVICES, S.C.

Practice address

7531 S Stony Island Ave
Chicago, IL 60649-3954

Phone

(773) 947-7500

Fax

(773) 947-7760

NPI assigned

Jun 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Douglas P. Webster, D.O.

Title

President/Owner

Phone

(800) 732-1066

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1689618241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41494",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191011494",
            "telephone_number": "800-732-1066",
            "fax_number": "630-941-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-7500",
            "fax_number": "773-947-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS/INDIANA EM-I MEDICAL SERVICES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "800-732-1066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK3056",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Chicago, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.