NPIMap

Organization Active NPI

Presence St. Joseph Hospital - Elgin

  • Nurse Practitioner
  • Elgin, IL
National Provider Identifier
1962849083
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
PRESENCE ST. JOSEPH HOSPITAL - ELGIN
Practice address
77 N Airlite St
Elgin, IL 60123-4912
Phone
(847) 742-4646
Fax
(847) 622-3460
NPI assigned
May 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Authorized official

Name
Melvonne Jones
Title
Manager, Credentialing
Phone
(630) 914-2417

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

77 N Airlite St
Elgin, IL 60123-4912

Mailing address

1000 Remington Blvd
Suite 100
Bolingbrook, IL 60440-5114
Phone (630) 914-2417

Other names 1

  • HEART FAILURE & ANTICOAGULATION CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Medcial Cente16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369872000000",
    "number": "1962849083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 REMINGTON BLVD",
            "address_2": "SUITE 100",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405114",
            "telephone_number": "630-914-2417",
            "fax_number": "630-914-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N AIRLITE ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234912",
            "telephone_number": "847-742-4646",
            "fax_number": "847-622-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE ST. JOSEPH HOSPITAL - ELGIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-30",
        "last_updated": "2013-05-30",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MELVONNE",
        "authorized_official_title_or_position": "MANAGER, CREDENTIALING",
        "authorized_official_telephone_number": "630-914-2417"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEART FAILURE & ANTICOAGULATION CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; 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.