PROGRESSIVE MEDICAL CENTER SC
NPI 1629128319
Internal Medicine in Addison, IL
NPI Status: Active since January 12, 2007
Contact Information
414 W LAKE STREET
ADDISON, IL
ZIP 60101
Phone: (630) 458-1905
Fax: (630) 458-1908
- Organization
- Internal Medicine
- Accepts Insurance
- CLIA Number: 14D0885998
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-24-2027
About PROGRESSIVE MEDICAL CENTER SC
This page provides the complete NPI Profile along with additional information for Progressive Medical Center Sc, an internist established in Addison, Illinois operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1629128319 assigned on January 2007. The practitioner's primary taxonomy code is 207R00000X with license number 036087152 (IL). The provider is registered as an organization and their NPI record was last updated 14 years ago. Progressive Medical Center Sc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Gabriela Henriquez (Office Manager)
- NPI
- 1629128319
- Provider Name
- PROGRESSIVE MEDICAL CENTER SC
- Entity Type
- Organization
- Location Address
- 414 W LAKE STREET ADDISON, IL 60101
- Location Phone
- (630) 458-1905
- Location Fax
- (630) 458-1908
- Mailing Address
- 1841 W ARMY TRAIL RD ADDISON, IL 60101
- Mailing Phone
- (630) 238-9235
- Mailing Fax
- (630) 458-1908
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-12-2007
- Last Update Date
- 04-07-2011
- Code Navigator
An internist like Progressive Medical Center Sc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036087152
- License State
- IL
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | 036103673 (IL) |
| 2 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | 036107571 (IL) |
| 3 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | 036078267 (IL) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? 901 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 352610 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL | |
| 373120 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL | |
| K14000 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL | |
| 036103673 | MEDICAID (05) | IL | |
| 036109448 | MEDICAID (05) | IL | |
| 110153602 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL | |
| 036078267 | MEDICAID (05) | IL | |
| G05846 | MEDICARE UPIN (02) | IL | |
| 937192 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL | |
| 110153600 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL | |
| 036087152 | MEDICAID (05) | IL | |
| H53956 | MEDICARE UPIN (02) | IL | |
| I24586 | MEDICARE UPIN (02) | IL | |
| E40859 | MEDICARE UPIN (02) | IL | |
| CF9448 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL | |
| 2205538 | OTHER (01) | IL | BCBS OF ILLINOIS |
| P00311497 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL | |
| 200566 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL | |
| ========= | OTHER (01) | IL | TAX ID |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D0885998
- Facility Type
- Physician Office
- Certificate Effective Date
- June 25, 2025
- Certificate Expiration Date
- June 24, 2027
- Laboratory Director
- AUSENCIO NUNEZ, MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Progressive Medical Center Sc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 2 | 9 | 1 | 2 | 8 | 3 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 4 | 9 | 2 | 2 | 16 | 3 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 4 + 9 + 2 + 2 + 1 + 6 + 3 + 2 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1629128319 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629128319, enumerated as an "organization" on January 12, 2007.
The provider is located at 414 W LAKE STREET ADDISON, IL 60101 and the phone number is (630) 458-1905.
Internal Medicine with taxonomy code 207R00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Medicare,. Please consult your insurance carrier or call the provider to verify.
