Active NPI
James A Richardson, MD
- Emergency Medicine Physician
- Hazel Crest, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036-088445
- Practice address
- 17800 Kedzie Ave
Hazel Crest, IL 60429-2029 - Phone
- (708) 213-4200
- Fax
- (708) 213-0144
- NPI assigned
- Jan 19, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036-088445 | IL | Primary |
| Emergency Medicine Physician | 207P00000X | 82317 | GA |
Addresses
Primary practice location
17800 Kedzie Ave
Hazel Crest, IL 60429-2029
Mailing address
29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900
Other practice location 1
4800 Olde Towne Pkwy Ste 150A
Marietta, GA 30068-4357
Phone (770) 509-1025
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 930036628 | Other | IL | RAILROAD MEDICARE |
| 03608844502 | Medicaid | IL | |
| P00372589 | Other | IL | RAILROAD MEDICARE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | jrichardson205067@direct.myadvocateaurora.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82317 | GA | MD | Emergency Medicine Physician |
| 036-088445 | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health & Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Northside Primary Care Professional Services,LLC | Past | Accepting new patients |
Locations
595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866
29373 Network Pl
Chicago, IL 60673
17800 Kedzie Ave
Hazel Crest, IL 60429
Phone (708) 213-4200
10811 W 143rd St
Ste 100
Orland Park, IL 60467
Phone (708) 460-2500
1700 Luther Ln
Fl 3
Park Ridge, IL 60068
Phone (414) 732-9399
18210 La Grange Rd
Ste 110
Tinley Park, IL 60487
Phone (708) 428-2500
18210 La Grange Rd
Ste 1
Tinley Park, IL 60487
Phone (708) 428-2500
Interoperability endpoints
- jrichardson205067@direct.myadvocateaurora.org
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Medical Specialty Clinic/Center
- Oak Lawn, IL
- NPI 1912936014
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- Family Medicine Physician
- Atlanta, GA
- NPI 1922397553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668729600000",
"number": "1790765584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29373 NETWORK PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731293",
"telephone_number": "847-390-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17800 KEDZIE AVE",
"city": "HAZEL CREST",
"state": "IL",
"postal_code": "604292029",
"telephone_number": "708-213-4200",
"fax_number": "708-213-0144"
}
],
"practiceLocations": [
{
"address_1": "4800 Olde Towne Pkwy Ste 150A",
"address_purpose": "LOCATION",
"city": "Marietta",
"state": "GA",
"postal_code": "300684357",
"country_code": "US",
"telephone_number": "770-509-1025",
"fax_number": "770-509-1884",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RICHARDSON",
"first_name": "JAMES",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2022-11-18",
"certification_date": "2022-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036-088445",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "82317",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "930036628",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03608844502",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00372589",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "17800 Kedzie Ave",
"city": "Hazel Crest",
"state": "IL",
"country_code": "US",
"postal_code": "604292029",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jrichardson205067@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "17800 Kedzie Ave",
"city": "Hazel Crest",
"state": "IL",
"country_code": "US",
"postal_code": "604292029",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Nov 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.