Coralis Health, LLC

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

Legal business name

CORALIS HEALTH, LLC

Practice address

4 Walker Ave Ste B
Clarendon Hills, IL 60514-1351

Phone

(708) 722-6218

NPI assigned

Sep 27, 2023

Last updated

Nov 13, 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

Angelica Robles, MDNPI 1609132059

Title

Chief Medical Officer

Phone

(980) 890-8668

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 5

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.

• Angelica Victoria Robles, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Charlotte, NC
  • NPI 1609132059
  Medicare reassignment Authorized official
• Ayesha Cheema-Hasan, MD

  • Developmental - Behavioral Pediatrics Physician
  • Clarendon Hills, IL
  • NPI 1679597637
  NPD
• Keith Ganci, PHD

  • Clinical Neuropsychologist
  • Charlotte, NC
  • NPI 1699028431
  NPD
• Robert P Collins, PHD

  • Psychologist
  • Charlotte, NC
  • NPI 1164461471
  NPD (past)
• Wade D Williams, PHD

  • Psychologist
  • Charlotte, NC
  • NPI 1760424634
  NPD (past)

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1891574927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 W DIVISION ST STE 360",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102419",
            "telephone_number": "708-722-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WALKER AVE STE B",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "605141351",
            "telephone_number": "708-722-6218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 W Division St Ste 360",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606102419",
            "country_code": "US",
            "telephone_number": "708-722-6061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 S Sharon Amity Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282112897",
            "country_code": "US",
            "telephone_number": "980-890-8668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "615 Main St",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372063603",
            "country_code": "US",
            "telephone_number": "615-866-1750",
            "fax_number": "833-471-2100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 E 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992022225",
            "country_code": "US",
            "telephone_number": "509-590-0618",
            "fax_number": "833-471-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CORALIS HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-27",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "ROBLES",
        "authorized_official_first_name": "ANGELICA",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "980-890-8668",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Chiaramonte, ATC, RKT, MHA
• Jill Chmielewski, RN
• Clarendon Pharmacy
• CMK Home Health Agency Inc
• Julianne M Confalonieri, MA
• Suzy D'Aprile
• Lisa D'Eramo, D.C.
• Ramzi Daibis, DDS, MS
• Janea Michelle Davis, M.S.
• Doctors General Laboratory Corp

• Developmental - Behavioral Pediatrics Physician in Clarendon Hills, IL
• Providers in Clarendon Hills, IL by specialty
• Developmental - Behavioral Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.