Active NPI
Aminat Abisola Ishadimu
- Case Manager/Care Coordinator
- South Holland, IL
National Provider Identifier
1922597186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 530 E 162ND St
South Holland, IL 60473-2326 - Phone
- (708) 825-1986
- NPI assigned
- May 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
530 E 162ND St
South Holland, IL 60473-2326
Mailing address
3670 School Dr
Country Club Hills, IL 60478-4949
Phone (708) 203-0309
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525305600000",
"number": "1922597186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3670 SCHOOL DR",
"city": "COUNTRY CLUB HILLS",
"state": "IL",
"postal_code": "604784949",
"telephone_number": "708-203-0309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 E 162ND ST",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "604732326",
"telephone_number": "708-825-1986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISHADIMU",
"first_name": "AMINAT",
"middle_name": "ABISOLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-03",
"last_updated": "2018-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Holland, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.