Individual provider Active NPI

Biju Cherian, PA-C

  • Physician Assistant
  • North Chicago, IL
National Provider Identifier
1003219619
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-005196 Issued in IL
Practice address
3001 Green Bay Rd
Captain James a. Lowell FHCC, Dept. of Cardiology
North Chicago, IL 60064-3048
Phone
(224) 610-8201
NPI assigned
Sep 27, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-005196 IL Primary
Physician Assistant 363A00000X 23-017858 NY

Addresses

Primary practice location

3001 Green Bay Rd
Captain James a. Lowell FHCC, Dept. of Cardiology
North Chicago, IL 60064-3048

Mailing address

1504 W Portage CT
Palatine, IL 60067-9202
Phone (847) 858-1342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085-005196ILMDPhysician Assistant
23-017858NYMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1003219619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 W PORTAGE CT",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600679202",
            "telephone_number": "847-858-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD",
            "address_2": "CAPTAIN JAMES A. LOWELL FHCC, DEPT. OF CARDIOLOGY",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048",
            "telephone_number": "224-610-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERIAN",
        "first_name": "BIJU",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-27",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-005196",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "23-017858",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.