Evergreen Emergency Services, LTD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

Legal business name

EVERGREEN EMERGENCY SERVICES, LTD

Practice address

2800 W 95TH St
Evergreen Park, IL 60805-2701

Phone

(708) 422-4221

Fax

(708) 422-4415

NPI assigned

Dec 14, 2005

Organization subpart

No

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

Authorized official

Name

Kathleen Guerrero

Title

Administrator

Phone

(708) 422-4221

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1881679678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42898",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608050898",
            "telephone_number": "708-422-4221",
            "fax_number": "708-422-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052701",
            "telephone_number": "708-422-4221",
            "fax_number": "708-422-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN EMERGENCY SERVICES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-14",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "GUERRERO",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-422-4221"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medical Services (Emergency Medicine) Physician in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.