Neptune

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

11O49IK Issued in ZZ

Legal business name

NEPTUNE

Practice address

2189 N Il Route 83 Ste 220
Round Lake Beach, IL 60073-4906

Phone

(312) 857-5382

NPI assigned

Feb 21, 2016

Organization subpart

No

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

Authorized official

Name

Kumar Dinesh

Title

Director

Phone

(312) 857-5382

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1456012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1720447667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2189 N IL ROUTE 83 STE 220",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600734906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2189 N IL ROUTE 83 STE 220",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600734906",
            "telephone_number": "312-857-5382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPTUNE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-21",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "DINESH",
        "authorized_official_first_name": "KUMAR",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "312-857-5382"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "ZZ",
            "license": "11O49IK",
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meijer Great Lakes Limited Partnership
• Midwestern Institute of Health LTD
• Teresita Mismanos, MD
• Sara Montague
• Ana Marie Navarrete
• Melissa J O'Donnell, LCSW
• Oak Hill Pathway LLC
• Oak Hill SP LLC
• Open Advanced MRI of Round Lake, LLC
• Uchenna Nneka Osayimwen

• Internal Medicine Physician in Round Lake Beach, IL
• Providers in Round Lake Beach, 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 May 9, 2016; 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.