NPIMap

Individual provider Active NPI

Ronald Anthony Hickombottom, M.D

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1023020989
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.065509 Issued in IL
Practice address
4009 N Broadway St
Chicago, IL 60613-2110
Phone
(773) 275-2586
NPI assigned
Aug 12, 2006
Last updated
Feb 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.065509 IL Primary

Addresses

Primary practice location

4009 N Broadway St
Chicago, IL 60613-2110

Mailing address

4009 N Broadway St
Chicago, IL 60613-2110
Phone (773) 275-2586

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041027000542 IL Practitioner - Internal Medicine 8527020171 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Meharry Medical College School of Medicine, 1981
Medicare assignment
May accept Medicare assignment
Group practices
Housecalls Done Wright LTDGroup PAC ID 5092148387, 8 clinicians

Practice addresses (Care Compare)

4021 W 63Rd St
Chicago, IL 60629-4642
Phone (773) 750-2571

9718 S Halsted St
Chicago, IL 60628-1007
Phone (773) 233-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.69 of 100Reported as group
Quality
87.19
Promoting interoperability
86
Improvement activities
40
Cost
40.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.065509ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Family Health Center, Inc. Current Accepting new patients
Housecalls Done Wright LTD Internal Medicine CurrentSince Nov 2, 2019 Accepting new patients
Christian Community Health Center CurrentSince Oct 1, 2024 Accepting new patients
Christian Community Health Center Current Accepting new patients
Wound Care Done Wright, LTD Internal Medicine CurrentSince Jul 2, 2025 Accepting new patients
DX Physical Therapy & Rehabilitation, LTD. Past Accepting new patients

Locations

364 Torrence Ave
Calumet City, IL 60409
Phone (708) 868-9457

4021 W 63rd St
Ste C
Chicago, IL 60629
Phone (312) 504-3277

9119 S Exchange Ave
Chicago, IL 60617

9718 S Halsted St
Chicago, IL 60628
Phone (773) 233-4100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14868/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/18277/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/4021/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ronald.hickombottom.1@14868.direct.athenahealth.com
  • Direct secure messaging: ronald.hickombottom.2@4021.direct.athenahealth.com

Organizations & group practices 7

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

Hospital & facility affiliations 7

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1023020989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132110",
            "telephone_number": "773-275-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132110",
            "telephone_number": "773-275-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKOMBOTTOM",
        "first_name": "RONALD",
        "middle_name": "ANTHONY",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.065509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.