Individual provider Active NPI

Maria Teresa Tam, MD

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1003843517
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036093565 Issued in IL
Practice address
2845 N Sheridan Rd
Ste 902
Chicago, IL 60657-7227
Phone
(773) 904-8641
Fax
(872) 888-1206
NPI assigned
Jun 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036093565 IL Primary

Addresses

Primary practice location

2845 N Sheridan Rd
Ste 902
Chicago, IL 60657-7227

Mailing address

2845 N Sheridan Rd
Suite 902
Chicago, IL 60657-7227
Phone (773) 904-8641

Other practice location 1

2800 N Sheridan Rd
Suite 205N
Chicago, IL 60657-6156
Phone (773) 904-8641

Other practice location 2

4250 Dempster St
Skokie, IL 60076-2008
Phone (733) 496-4532

Other identifiers 2

IdentifierTypeStateIssuer
036093565MedicaidIL
1620171OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040924000397 IL Practitioner - Obstetrics/Gynecology 0143298307 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thorek Memorial HospitalGroup PAC ID 4981593399, 49 clinicians

Practice addresses (Care Compare)

2845 N Sheridan Rd
Suite 902
Chicago, IL 60657-7227
Phone (773) 904-8641

840 W Irving Park Rd
Suite 305
Chicago, IL 60613-3011
Phone (773) 975-6775

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
All for Women Healthcare SC Obstetrics & Gynecology CurrentSince Jun 1, 2013 Accepting new patients
Community First Healthcare of Illinois, Inc. Current Accepting new patients
Community First Healthcare of Illinois, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Thorek Memorial Hospital CurrentSince May 13, 2017 Accepting new patients
Community First Healthcare of Illinois, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Thorek Memorial Hospital CurrentSince May 13, 2017 Accepting new patients
Lakeshore Womens Health Specialists SC Obstetrics & Gynecology Past Accepting new patients
Illinois Uvc Medical PLLC PastSince Nov 30, 2021 Accepting new patients
Community First Healthcare of Illinois, Inc Past Accepting new patients

Locations

840 W Irving Park Rd
#305
Chicago, IL 60613
Phone (773) 447-0200

331 W Surf St
Ste 902
Chicago, IL 60657
Phone (312) 337-3010

2800 N Sheridan Rd
Ste 205N
Chicago, IL 60657
Phone (773) 975-9957

2845 N Sheridan Rd
Ste 902
Chicago, IL 60657
Phone (773) 904-8641

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

4250 Dempster St
Skokie, IL 60076
Phone (847) 763-8850

Networks

  • IL HMO C-SNP
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • IL PPO Downstate

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1003843517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 N SHERIDAN RD",
            "address_2": "SUITE 902",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577227",
            "telephone_number": "773-904-8641",
            "fax_number": "872-888-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 N SHERIDAN RD",
            "address_2": "STE 902",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577227",
            "telephone_number": "773-904-8641",
            "fax_number": "872-888-1206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 N Sheridan Rd",
            "address_2": "Suite 205N",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606576156",
            "country_code": "US",
            "telephone_number": "773-904-8641",
            "fax_number": "872-888-1206",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4250 Dempster St",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600762008",
            "country_code": "US",
            "telephone_number": "733-496-4532",
            "fax_number": "872-888-1206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAM",
        "first_name": "MARIA TERESA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036093565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093565",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1620171",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.