Organization Active NPI

SW Medical Consultants Inc

  • Internal Medicine Physician
  • Palos Heights, IL
National Provider Identifier
1851636278
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036108097 Issued in IL
Legal business name
SW MEDICAL CONSULTANTS INC
Practice address
6400 W College Dr Ste 600
Palos Heights, IL 60463-1900
Phone
(708) 425-4662
Fax
(708) 425-4692
NPI assigned
Dec 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Authorized official

Name
Ms. Patricia A Wilson, NPNPI 1619338837
Title
NP
Phone
(708) 425-4662

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036108097 IL Primary

Addresses

Primary practice location

6400 W College Dr Ste 600
Palos Heights, IL 60463-1900

Mailing address

6400 W College Dr Ste 600
Palos Heights, IL 60463-1900
Phone (708) 389-3224

Other identifiers 1

IdentifierTypeStateIssuer
036108097MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130823001137 IL Part B Supplier - Clinic/Group Practice 0042453912 Receives reassigned benefits from 1 practitioner
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
14D0941608SW Medical Consultants Inc6400 College Drive Suite 600, Palos Heights, IL 60463Certificate of waiverApr 6, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1355184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1851636278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 W COLLEGE DR STE 600",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631900",
            "telephone_number": "708-389-3224",
            "fax_number": "708-425-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 W COLLEGE DR STE 600",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631900",
            "telephone_number": "708-425-4662",
            "fax_number": "708-425-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SW MEDICAL CONSULTANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-11",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "708-425-4662",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036108097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108097",
            "state": "IL"
        }
    ],
    "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 Sep 22, 2021; 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.