St. James Physician Hospital Organization

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

ST. JAMES PHYSICIAN HOSPITAL ORGANIZATION

Practice address

30 E 15TH St
Suite #402
Chicago Heights, IL 60411-3459

Phone

(708) 709-2011

Fax

(708) 709-2002

NPI assigned

Mar 27, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ravi Shetty

Title

Executive Director

Phone

(708) 709-2011

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952429045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 15TH ST",
            "address_2": "SUITE #402",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113459",
            "telephone_number": "708-709-2011",
            "fax_number": "708-709-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 15TH ST",
            "address_2": "SUITE #402",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113459",
            "telephone_number": "708-709-2011",
            "fax_number": "708-709-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JAMES PHYSICIAN HOSPITAL ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHETTY",
        "authorized_official_first_name": "RAVI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-709-2011"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St James Hospital and Health Care Center
• St James Hospital United States Catholic Conference (St James Diabetes)
• St James Hospital United States Catholic Conference (Franciscan St James Family Health Center of Chicago Heights)
• St James Hospital US Catholic Conference (St James Psychological Wellness)
• St James Hosptial (Alverno Home Infusion Service)
• Nelly Staines, OTR/L
• Walter B Stanford, D.D.S.
• Tyra Storey, AGPCNP
• David James Storm, D.D.S.
• Suburban Health and Rehabilitation Center

• Health Maintenance Organization in Chicago Heights, IL
• Providers in Chicago Heights, IL by specialty
• Health Maintenance Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.