Michigan Avenue Primary Care, S.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MICHIGAN AVENUE PRIMARY CARE, S.C.

Practice address

180 N Michigan Ave
Suite 1605
Chicago, IL 60601-7478

Phone

(312) 201-1234

Fax

(312) 201-1202

NPI assigned

Feb 24, 2010

Last updated

Jan 22, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James A Runke, MDNPI 1952425035

Title

Medical Director

Phone

(312) 201-1234

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mona Clor, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1932182003
  Medicare reassignment Care Compare group NPD
• Jeannette Suzanne Codere Kelly, D.O.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1154769081
  Medicare reassignment Care Compare group NPD
• Anne-Sophie Kim, MD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1285195396
  Medicare reassignment Care Compare group NPD
• James A Runke, M.D.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1952425035
  Medicare reassignment NPD Authorized official
• Niby Mathew, M.D.

  • Family Medicine Physician
  • Frankfort, IL
  • NPI 1184869125
  Medicare reassignment NPD
• Lauren Landerholm Miller, DO

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1790280881
  Medicare reassignment NPD
• Carrie Salvia, D.O.

  • Family Medicine Physician
  • Hometown, IL
  • NPI 1144675596
  Medicare reassignment NPD
• Jocelin Gamez, PA-C

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1881193001
  Medicare reassignment
• Nathan Jent, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1184296303
  Medicare reassignment
• Lester Stephen Montesa, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1144819285
  Medicare reassignment
• James Thomas Barrett, M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1407863210
  NPD (past)
• Tatiana A Batista, DO

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1972612760
  NPD (past)

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

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1013239672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "SUITE 1605",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017478",
            "telephone_number": "312-201-1234",
            "fax_number": "312-201-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "SUITE 1605",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017478",
            "telephone_number": "312-201-1234",
            "fax_number": "312-201-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN AVENUE PRIMARY CARE, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-24",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "RUNKE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "312-201-1234",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michigan Avenue Center for Health, LTD.
• Michigan Avenue ENT P.C.
• Michigan Avenue Hearing Health P.C.
• Michigan Avenue Immediate Care
• Michigan Avenue Internists
• Michigan Avenue Psychotherapy, LLC
• Michigan Chicago CVS LLC (CVS Pharmacy)
• Ruth Michon, NP
• Victoria Michonski, CD
• Michrid Supplies LLC

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.