Bella T Prospero, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036058672 Issued in IL

Practice address

17901 Governors Hwy
Suite 101
Homewood, IL 60430-1144

Phone

(708) 799-7193

Fax

(708) 799-3839

NPI assigned

Jul 28, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cressa Perish MD SC

  • Family Medicine Physician
  • Flossmoor, IL
  • NPI 1467553743
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1699775916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1119",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604434119",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 GOVERNORS HWY",
            "address_2": "SUITE 101",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301144",
            "telephone_number": "708-799-7193",
            "fax_number": "708-799-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSPERO",
        "first_name": "BELLA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036058672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058672",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL GROUP NUMBER",
            "identifier": "01635492",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prestige Healthcare Services of Illinois
• Beth Simon Price
• Priority One Healthcare LLC
• Professional Accounts Receivable Management Team
• Progressive Therapeutic Services
• Tammy Latrece Pruitt
• Psygenic Health Inc
• Shelby Catherine Pupo, M.ED.
• Vivian Ann Purnell, OTR/L
• Purposeful Pathways Counseling PLLC

• Internal Medicine Physician in Homewood, IL
• Providers in Homewood, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; 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.