Organization Active NPI

Mathers Clinic, LLC

  • Community/Behavioral Health Agency
  • Elgin, IL
National Provider Identifier
1821457714
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
036054365 Issued in IL
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

Updated by the provider on Jan 31, 2017

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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.

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.