Carli Jean Edwards

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036.166635 Issued in IL

Practice address

4220 W 95TH St
Oak Lawn, IL 60453-2793

Phone

(708) 684-5341

Fax

(708) 423-1899

NPI assigned

Mar 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1841877503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532793",
            "telephone_number": "708-684-5341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532793",
            "telephone_number": "708-684-5341",
            "fax_number": "708-423-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CARLI",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.166635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard J Eber, DDS
• Daniel Eckroth, M.D.
• Eco Friendly Dentistry PC
• Edens Opticians, Inc.
• Edward Hines Jr. VA Hospital
• Latoya Keshawn Edwards, LCSW
• John T Eed, MD
• Rebecca Ann Egan
• Robert Terrell Egel, M.D.
• Matthew Eggert, PT, DPT

• Pediatrics Physician in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.

Verify at the official NPI Registry.