Evernorth Direct Health LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EVERNORTH DIRECT HEALTH LLC

Practice address

700 25TH Ave
Bellwood, IL 60104-1908

Phone

(708) 547-2667

NPI assigned

Feb 13, 2020

Organization subpart

Yes

Parent organization

EVERNORTH DIRECT HEALTH LLCAs reported in NPPES

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

Authorized official

Name

Deborah Sue Coolidge

Title

Financial Analysis Senior Manager

Phone

(623) 277-1170

Specialties & licenses 1

Addresses

Other names 1

• Borg Warner - Bellwood Other name

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

CLIA laboratory certificates

Tax ID family

Evernorth Direct Health LLC102 organizations share this tax ID, including this one

Part of

Evernorth Direct Health LLC

Organizations with this tax ID in the same state 2

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Evernorth Direct Health LLC

  • Clinic/Center
  • Frankfort, IL
  • NPI 1083247506
  NPD tax ID
• Evernorth Direct Health LLC

  • Clinic/Center
  • Dixon, IL
  • NPI 1659956910
  NPD tax ID

Locations

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1710510235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 25TH AVE",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601041908",
            "telephone_number": "708-547-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 25TH AVE",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601041908",
            "telephone_number": "708-547-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERNORTH DIRECT HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERNORTH DIRECT HEALTH LLC",
        "enumeration_date": "2020-02-13",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "COOLIDGE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "FINANCIAL ANALYSIS SENIOR MANAGER",
        "authorized_official_telephone_number": "623-277-1170"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Borg Warner - Bellwood",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Borg Warner - Bellwood",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karibia Davis
• Sabrina Davis
• Robeela Deans, NP
• Kimberly Duboise, D.T
• Arterrya Edmond
• Alicia D Ferguson, PT
• Dawn Garcia, PTA
• Ana K Gilman, NP-C
• Julie Grobbelaar Fernandes, OT
• Ashley Harrison Ragle, MD

• Clinic/Center in Bellwood, IL
• Providers in Bellwood, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.