Organization Active NPI

John V. McInerney DO SC

  • Specialist
  • Palos Heights, IL
National Provider Identifier
1841354917
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036070352 Issued in IL
Legal business name
JOHN V. MCINERNEY DO SC
Practice address
11824 Southwest Hwy
Palos Heights, IL 60463-1055
Phone
(708) 923-1919
Fax
(708) 923-9922
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John McInerney, DONPI 1699727503
Title
Owner
Phone
(708) 923-1919

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 036070352 IL Primary

Addresses

Primary practice location

11824 Southwest Hwy
Palos Heights, IL 60463-1055

Mailing address

11824 Southwest Hwy
Palos Heights, IL 60463-1055
Phone (708) 923-1919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080916000659 IL Part B Supplier - Clinic/Group Practice 2668549643 Receives reassigned benefits from 3 practitioners
Practice locations: Palos Heights, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0944821John V McInerney DO, SC11824 Southwest Highway, Ste 200, Palos Heights, IL 60463Certificate of waiverApr 20, 2028

National Provider Directory

National Provider Directory

Locations

11824 Southwest Hwy
Ste 230
Palos Heights, IL 60463
Phone (708) 671-1175

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1841354917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11824 SOUTHWEST HWY",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631055",
            "telephone_number": "708-923-1919",
            "fax_number": "708-923-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11824 SOUTHWEST HWY",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631055",
            "telephone_number": "708-923-1919",
            "fax_number": "708-923-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN V. MCINERNEY DO SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "MCINERNEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-923-1919",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036070352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.