Medicaid Support, LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

MEDICAID SUPPORT, LLC

Practice address

21660 W Field Pkwy
Deer Park, IL 60010-7265

Phone

(847) 512-3579

Fax

(866) 578-1828

NPI assigned

Mar 22, 2024

Last updated

Mar 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yisraela Yehudah

Title

Ceo

Phone

(847) 512-3579

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1861242042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 517",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600110517",
            "telephone_number": "877-512-3579",
            "fax_number": "866-578-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21660 W FIELD PKWY",
            "city": "DEER PARK",
            "state": "IL",
            "postal_code": "600107265",
            "telephone_number": "847-512-3579",
            "fax_number": "866-578-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAID SUPPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "YEHUDAH",
        "authorized_official_first_name": "YISRAELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-512-3579"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Deer Park, IL
• Providers in Deer Park, IL by specialty
• Case Management Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.