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PROGRESSIVE MEDICAL CENTER SC
NPI 1629128319
Internal Medicine in Addison, IL

Active since January 12, 2007CLIA 14D0885998 · Waiver
414 W LAKE STREET, ADDISON, IL 60101(630) 458-1905(630) 458-1908 Get Directions Write a Review

NPPES record last updated: April 7, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Progressive Medical Center Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROGRESSIVE MEDICAL CENTER SC (NPI 1629128319) is a healthcare organization registered as an internal medicine in Addison, Illinois and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through June 24, 2027 and lists Gabriela Henriquez, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1629128319
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePROGRESSIVE MEDICAL CENTER SC
Location Address414 W LAKE STREETAddison, IL 60101
Mailing Address1841 W Army Trail RdAddison, IL 60101-1901 · (630) 238-9235 · Fax (630) 620-0581
Phone(630) 458-1905
Fax(630) 458-1908
Organization SubpartNo
Authorized OfficialGabriela HenriquezOffice Manager · (630) 238-9235
Enumeration DateJanuary 12, 2007
Last NPPES UpdateApril 7, 2011
✔ NPI 1629128319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036087152
Definition
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.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 036103673 (IL), 036107571 (IL)
Also ListedPediatricsTaxonomy 208000000X · License 036078267 (IL)
414 W LAKE STREET, Addison, IL 60101
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Other Identifiers 18

Medicare ID-Type Unspecified352610IL
Medicare ID-Type Unspecified373120IL
Medicare ID-Type UnspecifiedK14000IL
Medicaid036103673IL
Medicaid036109448IL
Medicare ID-Type Unspecified110153602IL
Medicaid036078267IL
Medicare UPING05846IL
Medicare ID-Type Unspecified937192IL
Medicare ID-Type Unspecified110153600IL
Medicaid036087152IL
Medicare UPINH53956IL
Medicare UPINI24586IL
Medicare UPINE40859IL
Medicare ID-Type UnspecifiedCF9448IL
Other2205538IL · Bcbs Of Illinois
Medicare ID-Type UnspecifiedP00311497IL
Medicare ID-Type Unspecified200566IL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0885998

Progressive Medical Center · Addison, IL
Active · expires Jun 24, 2027
CLIA Number14D0885998
Laboratory TypePhysician Office
Certificate Effective DateJune 25, 2025
Certificate Expiration DateJune 24, 2027
Laboratory DirectorAusencio Nunez, MD
Laboratory Phone(630) 238-9235
Laboratory LocationProgressive Medical Center1841 W Army Trail Rd, Addison, IL 60101
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Progressive Medical Center Sc's NPI number?

The NPI number for Progressive Medical Center Sc is 1629128319. It was assigned to this organization in the NPPES registry on January 12, 2007.

Where is Progressive Medical Center Sc located?

Progressive Medical Center Sc is located at 414 W Lake Street, Addison, IL 60101. The listed phone number is (630) 458-1905.

What is Progressive Medical Center Sc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Progressive Medical Center Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0885998) is associated with this NPI, valid through June 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Progressive Medical Center Sc was last updated on April 7, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.