Active NPI
Carlos Bolmey, MD
- Family Medicine Physician
- Schiller Park, IL
National Provider Identifier
1790731610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 069078634
- Practice address
- 9651 Irving Park Rd
Schiller Park, IL 60176-1905 - Phone
- (847) 671-2693
- Fax
- (847) 671-2907
- NPI assigned
- May 25, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 069078634 | IL | Primary |
Addresses
Primary practice location
9651 Irving Park Rd
Schiller Park, IL 60176-1905
Mailing address
9651 Irving Park Rd
Schiller Park, IL 60176-1905
Phone (847) 671-2693
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036078634 | 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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 069078634 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gottlieb Memorial Hospital | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Melrose Park, IL
- NPI 1831170232
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253059200000",
"number": "1790731610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9651 IRVING PARK RD",
"city": "SCHILLER PARK",
"state": "IL",
"postal_code": "601761905",
"telephone_number": "847-671-2693",
"fax_number": "847-671-2907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9651 IRVING PARK RD",
"city": "SCHILLER PARK",
"state": "IL",
"postal_code": "601761905",
"telephone_number": "847-671-2693",
"fax_number": "847-671-2907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLMEY",
"first_name": "CARLOS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2009-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "069078634",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036078634",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Schiller Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.