NPIMap

Organization Active NPI

Haveric Medical LTD

  • Internal Medicine Physician
  • Joliet, IL
National Provider Identifier
1881624047
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HAVERIC MEDICAL LTD
Practice address
333 N Madison St
Joliet, IL 60435
Phone
(815) 725-7133
Fax
(630) 455-6224
NPI assigned
Jul 4, 2006
Last updated
Jan 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Authorized official

Name
Dr. Zlatko Haveric, M.D.NPI 1568492726
Title
President
Phone
(815) 436-6814

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 Physician 207R00000X IL Primary

Addresses

Primary practice location

333 N Madison St
Joliet, IL 60435

Mailing address

PO Box 621
Hinsdale, IL 60522-0621
Phone (815) 436-6814

Other identifiers 1

IdentifierTypeStateIssuer
9932317OtherILBLUESHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050310000911 IL Part B Supplier - Clinic/Group Practice 0547214694 Receives reassigned benefits from 10 practitioners
Practice locations: Willowbrook, IL; Bolingbrook, IL; Shorewood, IL; Romeoville, IL; Plainfield, IL; New Lenox, IL; Lemont, IL; Joliet, IL…

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1881624047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 621",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605220621",
            "telephone_number": "815-436-6814",
            "fax_number": "630-455-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N MADISON ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "60435",
            "telephone_number": "815-725-7133",
            "fax_number": "630-455-6224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVERIC MEDICAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "HAVERIC",
        "authorized_official_first_name": "ZLATKO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-436-6814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "9932317",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.