Organization Active NPI

Charles R Harris & Associates LTD

  • Neurology Physician
  • Chicago, IL
National Provider Identifier
1023172392
Registry record updated Aug 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036060209 Issued in IL
Legal business name
CHARLES R HARRIS & ASSOCIATES LTD
Practice address
10628 S Longwood Dr
Chicago, IL 60643-2617
Phone
(312) 969-4333
Fax
(773) 751-2250
NPI assigned
Dec 21, 2006
Last updated
Aug 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2012

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

Authorized official

Name
Dr. Charles R Harris, M.D.
Title
President
Phone
(312) 969-4333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036060209 IL Primary

Addresses

Primary practice location

10628 S Longwood Dr
Chicago, IL 60643-2617

Mailing address

10628 S Longwood Dr
Chicago, IL 60643-2617
Phone (312) 969-4333

Other identifiers 1

IdentifierTypeStateIssuer
036060209MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345420800000",
    "number": "1023172392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10628 S LONGWOOD DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432617",
            "telephone_number": "312-969-4333",
            "fax_number": "773-751-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10628 S LONGWOOD DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432617",
            "telephone_number": "312-969-4333",
            "fax_number": "773-751-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES R HARRIS & ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2012-08-20",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-969-4333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036060209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036060209",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.