Active NPI
Axion Medical Group
- General Practice Physician
- Chicago, IL
National Provider Identifier
1922671437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- AXION MEDICAL GROUP
- Practice address
- 7118 S Jeffery Blvd
Chicago, IL 60649-2426 - Phone
- (702) 460-5799
- NPI assigned
- Jul 22, 2021
- Last updated
- Jul 22, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Allen Fobbs
- Title
- President
- Phone
- (702) 460-5799
Specialties & licenses 14
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Family Psychologist | 103TF0000X | |||
| Health Service Psychologist | 103TH0100X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Public Health & General Preventive Medicine Physician | 2083P0901X | |||
| General Practice Physician | 208D00000X | Primary | ||
| Primary Care Clinic/Center | 261QP2300X | |||
| Medical Physician Assistant | 363AM0700X | |||
| Adult Health Nurse Practitioner | 363LA2200X | |||
| Community Health Nurse Practitioner | 363LC1500X | |||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | |||
| Primary Care Nurse Practitioner | 363LP2300X | |||
| Health Psychologist | 103TH0004X | |||
| Prescribing (Medical) Psychologist | 103TP0016X |
Addresses
Primary practice location
7118 S Jeffery Blvd
Chicago, IL 60649-2426
Mailing address
10627 Country Knoll Way
Las Vegas, NV 89135-1258
Phone (702) 243-2777
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626912000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1626912000000",
"number": "1922671437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10627 COUNTRY KNOLL WAY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891351258",
"telephone_number": "702-243-2777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7118 S JEFFERY BLVD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606492426",
"telephone_number": "702-460-5799"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AXION MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2021-07-22",
"last_updated": "2021-07-22",
"certification_date": "2021-07-21",
"status": "A",
"authorized_official_last_name": "FOBBS",
"authorized_official_first_name": "ALLEN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "702-460-5799"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LC1500X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Community Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TP0016X",
"taxonomy_group": "",
"desc": "Psychologist, Prescribing (Medical)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
- Axess Clinic and Diagnostics LLC
- Axial Frost Clinic Il PC
- Axial Frost Clinic Il PC
- Axial Frost Clinic Il, PC
- Axial Spine & Wellness, LLC
- Axios Medical Equipment, Inc (Wound Care Solutions Inc)
- Axios Medical Equipment, Inc (Homescript Pharmacy SVCS)
- Axira Health, PLLC
- Axis Healthcare Services, Inc.
- Axis Home Care Services LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.