Beth Davis Phillpotts, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036089148 Issued in IL

Practice address

675 W North Ave
Suite 414
Melrose Park, IL 60160-1634

Phone

(708) 681-7858

Fax

(708) 681-7816

NPI assigned

Nov 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Presence Healthcare Services

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1093780181
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389139200000",
    "number": "1982686358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606173508",
            "telephone_number": "773-731-0670",
            "fax_number": "773-731-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "SUITE 414",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-681-7858",
            "fax_number": "708-681-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS PHILLPOTTS",
        "first_name": "BETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2014-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036089148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089148",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danetta Crusoe
• Nelsy Minelli Cruz, MSW
• Malgorzata Helena Cudzich Nowakowski
• Razan Dababneh
• Claudia Maria Dado, DDS
• Alicia Davis
• Dawn R Hackel DPM PC
• Liliana De Leon
• Robert Deangeles, DDS
• Nicole Decoudres, PA-C

• Family Medicine Physician in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.