Provider Demographics
NPI:1740163427
Name:SIMMONS, JAMES EDWARDS JR
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARDS
Last Name:SIMMONS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6133 S UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-2753
Mailing Address - Country:US
Mailing Address - Phone:773-306-8943
Mailing Address - Fax:
Practice Address - Street 1:1776 MOON LAKE BLVD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1010
Practice Address - Country:US
Practice Address - Phone:847-882-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician