Foundation for Emergency Services
Organization Active NPI Primary Care Clinic/Center · Chicago, IL
NPI 1992053029 · NPPES record last updated Apr 25, 2013
Key facts
- NPI
- 1992053029
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- 0002303 (IL)
- Legal business name
- FOUNDATION FOR EMERGENCY SERVICES
- Practice address
- 8331 S Stewart Ave
Chicago, IL 60620-1728 - Phone
- (773) 420-1234
- Fax
- (773) 420-1233
- NPI assigned
- Aug 21, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- ST BERNARD HOSPITAL
Authorized official
- Name
- Mr. Guy Richard Alton
- Title
- Chief Financial Officer
- Phone
- (773) 962-4073
Other NPIs on the same Medicare enrollment 1
Member of 1
Practitioners 79
-
Tahir A Abbasi, M.D.
-
Chowdary Adusumilli, M.D.
-
Afshan Jehan Ahmed, D.O.
-
Talha Ahmed, DO
-
Katrina Lee Basic, FNP-C, EMT-P
-
Jeffrey Bzdusek, DO
-
Carmesha Patrice Carrington, FNP-C
-
George Dengler, DO
-
Jessica Lynn Frith, FNP-BC
-
Rhonda Yvette Gans, M.D.
-
Nita Gupta, MD
-
Elina Kamaroff, D.O.
-
Marina Karamanis, DO
-
Soberekon Melvin Koko, M.D.
-
Gabriel Lathrop, DO, MS
-
Yixuan Liao, DO
-
Monica Logan, MD
-
Aslam Ahmed Mohammed, M.D.
-
Anthony D Murino, D.O.
-
Michael Murphy, D.O
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040113000338 | IL | Part B Supplier - Clinic/Group Practice | 4981504198 |
Receives reassigned benefits from 49 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Chicago, IL |
National Provider Directory
- Part of
- St Bernard Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 0002303 | IL | Yes |
Addresses
Primary practice location
8331 S Stewart Ave
Chicago, IL 60620-1728
Mailing address
PO Box 809616
Chicago, IL 60680-8802
Phone (773) 962-4073
Other names
- The Clinic at Walmart operated by St. Bernard Hospital
Other providers in Chicago, IL
- Anthony O Foulen
- Eric Sean Fouliard
- Douglas Foulke
- Oussama Founas
- Foundation for Emergency Services
- Foundation for Outreach Services
- Foundation Physical Therapy LLC
- Foundations Chicago, LLC
- Fountain of Health Home Health Agency LLC
- Fountain Psychotherapy & Consultation, PLLC
All providers in Chicago, IL · Primary Care Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.