NPIMap

Organization Active NPI

Roy J. Betti, M.D.S.C.

  • Clinic/Center
  • Carol Stream, IL
National Provider Identifier
1861650889
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ROY J. BETTI, M.D.S.C.
Practice address
381 S Schmale Rd
Suite B
Carol Stream, IL 60188-2782
Phone
(630) 653-5115
Fax
(630) 653-4493
NPI assigned
May 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Authorized official

Name
Dr. Roy Joseph Betti, M.D.
Title
President
Phone
(630) 653-5115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

381 S Schmale Rd
Suite B
Carol Stream, IL 60188-2782

Mailing address

381 S Schmale Rd
Suite B
Carol Stream, IL 60188-2782
Phone (630) 653-5115

Other identifiers 4

IdentifierTypeStateIssuer
036043734MedicaidIL
3631498336019001OtherILCDPG HFS PAYEE ID
02200852OtherILBLUE CROSS AND BLUE SHIELD
03000104OtherILILLINOIS HEALTH CONNECT

National Provider Directory

National Provider Directory

Locations

381 S Schmale Rd
Ste B
Carol Stream, IL 60188
Phone (630) 653-5115

Practitioners & affiliated clinicians

Practitioners 11

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": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1861650889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 S SCHMALE RD",
            "address_2": "SUITE B",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882782",
            "telephone_number": "630-653-5115",
            "fax_number": "630-653-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 S SCHMALE RD",
            "address_2": "SUITE B",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882782",
            "telephone_number": "630-653-5115",
            "fax_number": "630-653-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROY J. BETTI, M.D.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "BETTI",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-653-5115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036043734",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPG HFS PAYEE ID",
            "identifier": "3631498336019001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "02200852",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS HEALTH CONNECT",
            "identifier": "03000104",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carol Stream, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.