ENDO-MED CLINIC SC NPI 1538519251

NPI Information

  • NPI: 1538519251
  • Provider Name: ENDO-MED CLINIC SC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 14D2115248
  • Address: 2450 GLENWOOD AVE
    JOLIET, IL
    ZIP 60435
  • Phone: (815) 730-3304

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NPI Details

ENDO-MED CLINIC SC is a specialist in Joliet, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ENDO-MED CLINIC SC NPI is 1538519251. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2450 GLENWOOD AVE
JOLIET, IL
ZIP 60435-463
Phone: (815) 730-3304
Fax: (815) 730-3305

The provider's authorized official is Wassim El-harake .
The authorized official title is President and has the following contact phone number (815) 730-3304.

The CLIA number assigned to this NPI record is 14D2115248 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/14/2016 and was last updated on 6/14/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist036089327ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G44134MEDICARE UPINILLINOIS
21346236098MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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