CHICAGOLAND PHYSICIAN CONSORTIUM, LLC (NPI# 1720537384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720537384 |
| Entity Type | Organization |
| Organization Name | CHICAGOLAND PHYSICIAN CONSORTIUM, LLC |
| Practice Address |
3510 W 79th St Chicago IL 60652-1430 |
| Practice Telephone | 7734599661 |
| Practice Fax Number | 3126312892 |
| Mailing Telephone | 7734599661 |
| Mailing Fax Number | 3126312892 |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2017-09-07 |
| Authorized Official Name | DR. RUDYARD U SMITH (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7734599661 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians |
| Street Address |
3510 W 79TH ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60652-1430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720039373 | Quality Home Care Services Ltd | Home Health | 3510 W 79th St, Chicago, IL 60652-1430 | 2006-05-16 |
| 1164917720 | Mr.oak | Internal Medicine | 3510 W 79th St, Chicago, IL 60652-1430 | 2018-06-26 |
| 1083095293 | Richard Felicelda | Spec/Tech, Cardiovascular | 3510 W 79th St, Suite 4, Chicago, IL 60652-1430 | 2015-06-12 |
| 1568753259 | Accusci Labs Inc | Clinical Medical Laboratory | 3510 W 79th St, Suite 3, Chicago, IL 60652-1430 | 2011-04-28 |
| 1427093251 | Illiana Home Medical Equipment and Supplies LLC | Durable Medical Equipment & Medical Supplies | 3510 W 79th St, Chicago, IL 60652-1430 | 2006-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861042715 | New Hope Community Service Center | Clinic/Center | New Hope Community Service Center, 2559 West 79th, Chicago, IL 60652 | 2019-09-12 |
| 1770012189 | Rachel Pasternak | Social Worker | 3348 W 87th Street, Chicago, IL 60652 | 2017-06-08 |
| 1437682283 | Manliu Yang | Dentist | 8541 S Cicero Ave, Chicago, IL 60652 | 2017-04-08 |
| 1336687144 | Stephanie J. Wilson | Registered Nurse | 7600 S. Pulask Rd., Chicago, IL 60652 | 2017-02-01 |
| 1346786811 | Talisha Moman | Licensed Practical Nurse | 7600 S. Pulaski Rd., Suite 1106, Chicago, IL 60652 | 2017-01-09 |
| 1952851933 | Yvonne Caldwell | Licensed Practical Nurse | 8600 S. Pulaski, Road, Chicago, IL 60652 | 2016-10-13 |
| 1942605795 | Brittney Mclean | Developmental Therapist | 4317 W. 77th Pl, Chicago, IL 60652 | 2014-10-22 |
| 1245599521 | Chisa Marie Collins | Occupational Therapist | 8008 S Albany, Chicago, IL 60652 | 2012-05-08 |
| 1548572969 | St. Mary Therapy Services | Clinic/Center | 2455 W 79th St, #101, Chicago, IL 60652 | 2010-07-14 |
| 1750574752 | Curt R Lang | Dentist | 4651 W 79th St, Suite 208, Chicago, IL 60652 | 2007-08-22 |
| Find all providers in zip 60652 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902397078 | Rebecca Abraham | Hospitalist | 5145 N California Ave Ofc M331, Chicago, IL 60625 | 2018-05-24 |
| 1437544764 | Victoria Grace Behrend | Hospitalist | 259 East Erie St, Chicago, IL 60611 | 2015-04-02 |
| 1639562267 | Alexandra Steverson | Hospitalist | 2322 N Commonwealth Ave Apt 314, Chicago, IL 60614-3408 | 2015-03-06 |
| 1255774527 | Ketevan Gvalia | Hospitalist | 170 W Polk St Apt 1007, Chicago, IL 60605 | 2013-04-16 |
| 1518200468 | Amanda Bradke | Hospitalist | 1700 W Van Buren St Ste 500, Chicago, IL 60612 | 2013-03-28 |
| 1033421953 | Asim Mohammed Saeed | Hospitalist | 4332 N. Elston Ave., Chicago, IL 60641 | 2010-07-08 |
| 1437316882 | Sarah Koopmann | Hospitalist | 2951 S King Dr Apt 610, Chicago, IL 60616-3317 | 2008-05-21 |
| 1134140254 | Sabine Barbara Sobek | Hospitalist | 251 E. Huron St, Ste 16-738, Chicago, IL 60611 | 2006-07-22 |
| 1235162413 | Marianne Tschoe | Hospitalist | 251 E Huron St Ste 16-738, Chicago, IL 60611-2908 | 2006-07-09 |
| 1275581803 | Lawrence Yuen | Hospitalist | 251 E Huron St # 16-738, Chicago, IL 60611-2908 | 2006-05-05 |
| 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.