31St Street Medical Center S.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

31ST STREET MEDICAL CENTER S.C.

Practice address

16750 80TH Ave
Suite B
Tinley Park, IL 60477-3173

Phone

(708) 429-7373

Fax

(708) 429-7340

NPI assigned

Nov 14, 2007

Last updated

Nov 14, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sheldon Allen Levine, D.O.

Title

President

Phone

(708) 429-7373

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1750562187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16750 80TH AVE",
            "address_2": "SUITE B",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773173",
            "telephone_number": "708-429-7373",
            "fax_number": "708-429-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16750 80TH AVE",
            "address_2": "SUITE B",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773173",
            "telephone_number": "708-429-7373",
            "fax_number": "708-429-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "31ST STREET MEDICAL CENTER S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "SHELDON",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-429-7373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.