NPIMap

Organization Active NPI

Northern Illinois Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Algonquin, IL
National Provider Identifier
1770867954
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
NORTHERN ILLINOIS MEDICAL CENTER
Practice address
1118 North Main Street
Algonquin, IL 60102-3482
Phone
(815) 759-4444
NPI assigned
Oct 5, 2011
Last updated
Mar 21, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHERN ILLINOIS MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Authorized official

Name
David Tomlinson
Title
Cio & Cfo
Phone
(815) 788-5831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

1118 North Main Street
Algonquin, IL 60102-3482

Mailing address

213 Front St.
McHenry, IL 60050-5501
Phone (815) 759-4444

Other names 1

  • Centegra Home Medical Equipment Other name

National Provider Directory

National Provider Directory
Tax ID family
No Il Med CRT ER Physic4 organizations share this tax ID, including this one
Part of
No Il Med CRT ER Physic

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

213 Front St
McHenry, IL 60050
Phone (815) 382-3926

Practitioners & affiliated clinicians

Practitioners 1

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": "1317772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395360000000",
    "number": "1770867954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 FRONT ST.",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600505501",
            "telephone_number": "815-759-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 NORTH MAIN STREET",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601023482",
            "telephone_number": "815-759-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ILLINOIS MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHERN ILLINOIS MEDICAL CENTER",
        "enumeration_date": "2011-10-05",
        "last_updated": "2014-03-21",
        "status": "A",
        "authorized_official_last_name": "TOMLINSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CIO & CFO",
        "authorized_official_telephone_number": "815-788-5831"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centegra Home Medical Equipment",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Algonquin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; 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.