NPIMap

Individual provider Active NPI

Thaw Han, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1043889637
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125.078549 Issued in IL
Practice address
1625 E 75TH St
Chicago, IL 60649-3603
Phone
(773) 947-7310
NPI assigned
Jun 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A195603 CA
Internal Medicine Physician 207R00000X A195603 CA
Hospitalist Physician 208M00000X A195603 CA
Family Medicine Physician 207Q00000X 125.078549 IL Primary

Addresses

Primary practice location

1625 E 75TH St
Chicago, IL 60649-3603

Mailing address

1625 E 75TH St
Chicago, IL 60649-3603
Phone (773) 947-7310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250120000126 CA Practitioner - HospitalistPractitioner - Family PracticePractitioner - Internal Medicine 3678002730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice, Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

2615 Chester Ave
Bakersfield, CA 93301-2014
Phone (661) 395-3000

Hospital & facility affiliations

  • Adventist Health Bakersfield Hospital, Bakersfield, CA, CCN 050455
  • Adventist Health Tehachapi Valley Hospital, Tehachapi, CA, CCN 051301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.078549ILMDFamily Medicine Physician
A195603CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Oct 11, 2024 Accepting new patients
Galen Inpatient Physicians, PC Hospitalist Current Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Oct 11, 2024 Accepting new patients

Locations

2615 Chester Ave
Bakersfield, CA 93301
Phone (661) 381-7545

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

Organizations & group practices 13

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.

View all 13

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": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1043889637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 E 75TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493603",
            "telephone_number": "773-947-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E 75TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493603",
            "telephone_number": "773-947-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "THAW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A195603",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A195603",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A195603",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.078549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.