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MEDICAL ASSOCIATES OF CHATAM LTD NPI 1215267786


NPI Information

NPI: 1215267786
Provider Name: MEDICAL ASSOCIATES OF CHATAM, LTD
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 14D2042170

Address:
8541 S STATE ST
SUITE #9
CHICAGO, IL
ZIP 60619
Phone: (773) 488-2595
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MEDICAL ASSOCIATES OF CHATAM, LTD is a primary care clinic center in Chicago, IL. MEDICAL ASSOCIATES OF CHATAM, LTD NPI is 1215267786. The provider is registered as an organization entity type.

The provider's business location address is:

8541 S STATE ST
SUITE #9
CHICAGO, IL
ZIP 60619-665
Phone: (773) 488-2595
Fax: (773) 783-8561

The provider's authorized official is Vijaya K Sarma .
The authorized official title is Owner/president and has the following contact phone number (773) 488-2595.

The CLIA number assigned to this NPI record is 14D2042170 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/6/2010 and was last updated on 7/30/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QP2300XClinic/CenterPrimary Care036099712ILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H01032OTHERILLINOISUPIN
2036099712MEDICAIDILLINOIS
3204403MEDICARE PINILLINOIS

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.