Organization Active NPI

Neurology Consultants, S.C.

  • Neurology Physician
  • Hazel Crest, IL
National Provider Identifier
1730294943
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEUROLOGY CONSULTANTS, S.C.
Practice address
3330 W 177TH St
Suite 3C
Hazel Crest, IL 60429-2184
Phone
(708) 799-6799
NPI assigned
Aug 20, 2006
Last updated
Oct 31, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Authorized official

Name
Kenneth Winston Holmes, M.D.NPI 1114982477
Title
President
Phone
(708) 799-6799

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
Neurology Physician 2084N0400X IL Primary

Addresses

Primary practice location

3330 W 177TH St
Suite 3C
Hazel Crest, IL 60429-2184

Mailing address

3330 W 177TH St
Suite 3C
Hazel Crest, IL 60429-2184
Phone (708) 799-6799

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041025000254 IL Part B Supplier - Clinic/Group Practice 8628039534 Receives reassigned benefits from 3 practitioners
Practice locations: Chicago, IL; Hazel Crest, IL

National Provider Directory

National Provider Directory

Locations

111 N Wabash Ave
Ste 911
Chicago, IL 60602
Phone (708) 799-6799

505 N Lake Shore Dr
Ste 203
Chicago, IL 60611
Phone (312) 528-9068

Practitioners & affiliated clinicians

Practitioners 3

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1730294943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "SUITE 3C",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292184",
            "telephone_number": "708-799-6799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "SUITE 3C",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292184",
            "telephone_number": "708-799-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY CONSULTANTS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "WINSTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-799-6799",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.