Active NPI
Mathers Clinic, LLC
- Community/Behavioral Health Agency
- Elgin, IL
National Provider Identifier
1821457714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 036054365
- Legal business name
- MATHERS CLINIC, LLC
- Practice address
- 585 Tollgate Rd
Elgin, IL 60123-9323 - Phone
- (847) 462-6099
- Fax
- (847) 628-6064
- NPI assigned
- Feb 19, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ramesh B Vemuri, M.D.
- Title
- Owner
- Phone
- (815) 444-9999
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 036054365 | IL | Primary |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | IL |
Addresses
Primary practice location
585 Tollgate Rd
Elgin, IL 60123-9323
Mailing address
585 Tollgate Rd
Elgin, IL 60123-9323
Phone (847) 462-6099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110411000671 | IL | Part B Supplier - Clinic/Group Practice | 7214111582 |
Receives reassigned benefits from 23 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Woodstock, IL; Hoffman Estates, IL; Fox Lake, IL; East Dundee, IL; Crystal Lake, IL; Chicago, IL; Elgin, IL |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Community/Behavioral Health Agency
- Crystal Lake, IL
- NPI 1447610381
O20110411000671
-
- Community/Behavioral Health Agency
- Woodstock, IL
- NPI 1316307259
O20110411000671
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455840000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1485820800000",
"number": "1821457714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "585 TOLLGATE RD",
"city": "ELGIN",
"state": "IL",
"postal_code": "601239323",
"telephone_number": "847-462-6099",
"fax_number": "847-628-6064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "585 TOLLGATE RD",
"city": "ELGIN",
"state": "IL",
"postal_code": "601239323",
"telephone_number": "847-462-6099",
"fax_number": "847-628-6064"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MATHERS CLINIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-02-19",
"last_updated": "2017-01-31",
"status": "A",
"authorized_official_last_name": "VEMURI",
"authorized_official_first_name": "RAMESH",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "815-444-9999",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "IL",
"license": "036054365",
"primary": true
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": "IL",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.