Organization Active NPI

Corpsman Up Foundation

  • Home Health Agency
  • Calumet City, IL
National Provider Identifier
1730077041
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CORPSMAN UP FOUNDATION
Practice address
1156 Harding Ave
Calumet City, IL 60409-2451
Phone
(708) 275-7494
NPI assigned
Jun 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Authorized official

Name
Michael A Davis II
Title
Ceo
Phone
(708) 275-7494

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1156 Harding Ave
Calumet City, IL 60409-2451

Mailing address

1156 Harding Ave
Calumet City, IL 60409-2451
Phone (708) 275-7494

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1730077041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 HARDING AVE",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604092451",
            "telephone_number": "708-275-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 HARDING AVE",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604092451",
            "telephone_number": "708-275-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORPSMAN UP FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-275-7494",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calumet City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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.