Organization Active NPI

First Health Medical Center LLC

  • Primary Care Nurse Practitioner
  • Sycamore, IL
National Provider Identifier
1710670609
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
FIRST HEALTH MEDICAL CENTER LLC
Practice address
437 W State St Apt 101
Sycamore, IL 60178-1458
Phone
(630) 550-1058
Fax
(815) 205-4545
NPI assigned
May 29, 2023
Last updated
Jul 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Authorized official

Name
Deepak Sharma, APRNNPI 1053956292
Title
Nurse Practitioner
Phone
(630) 550-1058

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

437 W State St Apt 101
Sycamore, IL 60178-1458

Mailing address

1439 Snow Drift Cir
Bartlett, IL 60103-1572
Phone (630) 550-1058

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230821000455 IL Part B Supplier - Clinic/Group Practice 6901268168 Receives reassigned benefits from 1 practitioner
Practice locations: Elgin, IL

National Provider Directory

National Provider Directory

Locations

437 W State St
Apt 101
Sycamore, IL 60178
Phone (630) 550-1058

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1685318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1710670609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 SNOW DRIFT CIR",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031572",
            "telephone_number": "630-550-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 W STATE ST APT 101",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601781458",
            "telephone_number": "630-550-1058",
            "fax_number": "815-205-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST HEALTH MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-29",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "630-550-1058",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.