Active NPI
Corpsman Up Foundation
- Home Health Agency
- Calumet City, IL
National Provider Identifier
1730077041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryNPI 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.