NPIMap

Organization Active NPI

Diverge Health Aco of Northern Illinois

  • Case Management Agency
  • Glencoe, IL
National Provider Identifier
1902655202
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
DIVERGE HEALTH ACO OF NORTHERN ILLINOIS
Practice address
500 Adams Ave
Glencoe, IL 60022-1865
Phone
(941) 718-9000
NPI assigned
May 17, 2024
Last updated
May 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Authorized official

Name
Dr. Vincent Pantone, MDNPI 1710150263
Title
Cmo
Phone
(917) 684-7118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

500 Adams Ave
Glencoe, IL 60022-1865

Mailing address

500 Adams Ave
Glencoe, IL 60022-1865
Phone (941) 718-9000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1715904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1902655202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ADAMS AVE",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221865",
            "telephone_number": "941-718-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ADAMS AVE",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221865",
            "telephone_number": "941-718-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERGE HEALTH ACO OF NORTHERN ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "PANTONE",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "917-684-7118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glencoe, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.