NPIMap

Organization Active NPI

National Center for Integrative Medicine

  • Emergency Medicine Physician
  • Joliet, IL
National Provider Identifier
1912201310
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
36.060189 Issued in IL
Legal business name
NATIONAL CENTER FOR INTEGRATIVE MEDICINE
Practice address
3100 Theodore St
Joliet, IL 60435-8534
Phone
(815) 330-3100
Fax
(815) 330-3115
NPI assigned
Dec 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Authorized official

Name
Dr. Rao Kilaru, M.D.
Title
President/Ceo
Phone
(815) 330-3100

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 38.011832 IL
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 36.060189 IL Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 36.113633 IL
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 85.003604 IL

Addresses

Primary practice location

3100 Theodore St
Joliet, IL 60435-8534

Mailing address

3100 Theodore St
Joliet, IL 60435-8534
Phone (815) 330-3100

Other names 1

  • NCIM Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293580800000",
    "number": "1912201310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 THEODORE ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358534",
            "telephone_number": "815-330-3100",
            "fax_number": "815-330-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 THEODORE ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358534",
            "telephone_number": "815-330-3100",
            "fax_number": "815-330-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL CENTER FOR INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-29",
        "last_updated": "2010-12-29",
        "status": "A",
        "authorized_official_last_name": "KILARU",
        "authorized_official_first_name": "RAO",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "815-330-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "38.011832",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "36.060189",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36.113633",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "85.003604",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NCIM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Dec 29, 2010; 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.