Cory Cunningham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-001648 Issued in IL

Practice address

15901 Cicero Ave
Oak Forest, IL 60452-4005

Phone

(708) 633-1968

NPI assigned

Nov 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Health Service Systems, Inc

  • Internal Medicine Physician
  • New Lenox, IL
  • NPI 1851323257
  Medicare reassignment NPD
• Health Service Systems, Inc

  • Urgent Care Clinic/Center
  • Mokena, IL
  • NPI 1578235800
  NPD
• Midwest Emergency Northern Illinois Inc

  • Emergency Medicine Physician
  • Ottawa, IL
  • NPI 1427217504
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932271913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14707 LE CLAIRE AVE",
            "city": "MIDLOTHIAN",
            "state": "IL",
            "postal_code": "604453570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15901 CICERO AVE",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604524005",
            "telephone_number": "708-633-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "CORY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cook County
• Core Family Home Health Inc
• Mackenzie Coulter, CCC-SLP
• Covenant Enabling Residences of Illinois
• Covenant Enabling Residences of Illinois
• Colleen Curran, M.S.
• Kelsey M Dagenais, LCPC
• Lauren Elizabeth Danzie, RN
• Nivedita J Dave, MD
• David Chang Lee MD LTD

• Physician Assistant in Oak Forest, IL
• Providers in Oak Forest, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.