Active Medical Center LTD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ACTIVE MEDICAL CENTER LTD

Practice address

754 S 8TH St
West Dundee, IL 60118-2102

Phone

(847) 836-5202

Fax

(847) 836-5209

NPI assigned

May 17, 2016

Last updated

May 17, 2016By 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. Jeremy Joseph Darnell

Title

President

Phone

(847) 836-5202

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1821445180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 S 8TH ST",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601182102",
            "telephone_number": "847-836-5202",
            "fax_number": "847-836-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 S 8TH ST",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601182102",
            "telephone_number": "847-836-5202",
            "fax_number": "847-836-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE MEDICAL CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "DARNELL",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-836-5202",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in West Dundee, IL
• Providers in West Dundee, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.