Active NPI
Qaiyim Drew
- Home Health Agency
- Aurora, IL
National Provider Identifier
1790456747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 1723 Simms St Ste 202
Aurora, IL 60504-4703 - Phone
- (773) 732-2877
- Fax
- (708) 713-3020
- NPI assigned
- Sep 21, 2021
- Last updated
- Sep 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | NU | Primary |
Addresses
Primary practice location
1723 Simms St Ste 202
Aurora, IL 60504-4703
Mailing address
1723 Simms St Ste 202
Aurora, IL 60504-4703
Phone (773) 732-2877
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 852846842 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| QC Phlebotomy Labs Inc | Home Health | Current | Accepting new patients |
Locations
1723 Simms St
Ste 202
Aurora, IL 60504
Phone (708) 963-9500
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632182400000",
"number": "1790456747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1723 SIMMS ST STE 202",
"city": "AURORA",
"state": "IL",
"postal_code": "605044703",
"telephone_number": "773-732-2877",
"fax_number": "708-713-3020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1723 SIMMS ST STE 202",
"city": "AURORA",
"state": "IL",
"postal_code": "605044703",
"telephone_number": "773-732-2877",
"fax_number": "708-713-3020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DREW",
"first_name": "QAIYIM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-21",
"last_updated": "2021-09-21",
"certification_date": "2021-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "852846842",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.