NPIMap

Organization Active NPI

Apollo Medical Group of Kankakee LLC

  • Anesthesiology Physician
  • Bradley, IL
National Provider Identifier
1710418934
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
APOLLO MEDICAL GROUP OF KANKAKEE LLC
Practice address
403 S Kennedy Dr
Bradley, IL 60915-2152
Phone
(815) 928-9999
Fax
(815) 928-9916
NPI assigned
Mar 21, 2017
Last updated
Mar 21, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Authorized official

Name
Dr. Ayman Elfar, MD
Title
Member/Manager
Phone
(812) 455-7798

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

403 S Kennedy Dr
Bradley, IL 60915-2152

Mailing address

PO Box 1963
Indianapolis, IN 46206-1963
Phone (941) 360-1566

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490054400000",
    "number": "1710418934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1963",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061963",
            "telephone_number": "941-360-1566",
            "fax_number": "941-358-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 S KENNEDY DR",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609152152",
            "telephone_number": "815-928-9999",
            "fax_number": "815-928-9916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOLLO MEDICAL GROUP OF KANKAKEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-21",
        "status": "A",
        "authorized_official_last_name": "ELFAR",
        "authorized_official_first_name": "AYMAN",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "812-455-7798",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradley, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.