CHICAGO MONTICELLO MEDICAL CTR (NPI# 1447265053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447265053 |
| Entity Type | Organization |
| Organization Name | CHICAGO MONTICELLO MEDICAL CTR |
| Other Organization Name | MICHAEL W EARLY MD |
| Practice Address |
3623 W Chicago Ave Chicago IL 60651-3934 |
| Practice Telephone | 7737226171 |
| Practice Fax Number | 7737227913 |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2007-11-19 |
| Authorized Official Name | MICHAEL EARLEY (MD) |
| Authorized Official Telephone | 7737226171 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER | 1478723 | 01 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1478723 | 01 |
| Other Name | Type Code |
|---|---|
| MICHAEL W EARLY MD | Doing Business As Name - Organization |
| Street Address |
3623 W CHICAGO AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60651-3934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255398715 | Philip Alexander Maskall | Family Medicine | 3623 W Chicago Ave, Chicago, IL 60651-3934 | 2006-04-27 |
| 1922107952 | Michael William Earley | Family Medicine | 3623 W Chicago Ave, Chicago, IL 60651-3934 | 2006-09-22 |
| 1740394717 | Aruna H Patel | Pharmacy | 3623 W Chicago Ave, Chicago, IL 60651-3934 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215474978 | Kanesha Walker Amaro | Counselor | 5910 W Division, Chicago, IL 60651 | 2017-01-19 |
| 1639628415 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 3520 West Grand, Chicago, IL 60651 | 2016-09-22 |
| 1326596321 | Giselle Tisha Wallace | Nurse's Aide | 5809 W Rice, Chgo, IL 60651 | 2016-09-19 |
| 1811385214 | Jeanette Rodriguez | Social Worker | 1116 N Kedzie Av. Office#257, Association House of Chicago, Chicago, IL 60651 | 2015-01-07 |
| 1801147475 | Diane Dickens-rogers | Massage Therapist | 5700 W. Chicago Ave., Chicago, IL 60651 | 2012-09-24 |
| 1891045241 | Association House of Chicago | Residential Treatment Facility, Emotionally Disturbed Children | 1900 North Sawyer Avenue, Chicago, IL 60651 | 2012-09-13 |
| 1770860983 | Christine C Osborne | Pharmacist | 1541 N.central Ave, Chicago, IL 60651 | 2011-11-16 |
| 1629206388 | Habilitative Systems Inc | Case Management | 1049 N Drake Ave, Chicago, IL 60651 | 2009-07-01 |
| 1841428547 | Habilitative Systems, Inc. | Case Management | 4234 W Potomac Ave, Chicago, IL 60651 | 2009-07-01 |
| 1306074000 | Habilitative Systems, Inc | Case Management | 915 N Massasoit Ave, Chicago, IL 60651 | 2009-07-01 |
| Find all providers in zip 60651 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851889257 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 8501 W Higgins Rd Ste 100, Chicago, IL 60631-2814 | 2018-05-01 |
| 1922048677 | Carl B Toren Md | Non-Pharmacy Dispensing Site | 556 E 115th St, Chicago, IL 60628-5740 | 2006-06-08 |
| 1013957760 | Carl B Toren Md | Non-Pharmacy Dispensing Site | 9119 S Exchange Ave, Chicago, IL 60617-4225 | 2006-06-08 |
| 1467907741 | Foot & Ankle Healthcare Center Ltd | Non-Pharmacy Dispensing Site | 5501 W Belmont Ave, Chicago, IL 60641-4130 | 2016-08-17 |
| 1477944577 | Gold Coast Orthopaedic and Spine Surgery S C | Non-Pharmacy Dispensing Site | 33 W Delaware Pl, 1st Fl, Chicago, IL 60610-8115 | 2015-02-10 |
| 1639417496 | Jencare Neighborhood Medical Center Evergreen Park, LLC | Non-Pharmacy Dispensing Site | 2734 W 87th St, Chicago, IL 60652-3937 | 2013-01-29 |
| 1164768354 | Jencare Neighborhood Medical Center South Chicago, LLC | Non-Pharmacy Dispensing Site | 2231 E 95th St, Chicago, IL 60617-4804 | 2012-12-17 |
| 1669748018 | Peak Performance Health Center Ltd | Non-Pharmacy Dispensing Site | 1749 N Wells St, Chicago, IL 60614-5877 | 2012-03-30 |
| 1093097040 | Northwestern Memorial Physicians Group | Non-Pharmacy Dispensing Site | 1460 N Halsted St, Suite 502, Chicago, IL 60642-2605 | 2011-09-15 |
| 1629244223 | Michael C Molay Dpm | Non-Pharmacy Dispensing Site | 5485 N Milwaukee Ave, Chicago, IL 60630-1249 | 2008-05-02 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.