Orchid Suite Medical Group

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

03643976 Issued in IL

Legal business name

ORCHID SUITE MEDICAL GROUP

Practice address

8012 S Crandon Ave Ste 100
Chicago, IL 60617-1124

Phone

(773) 356-5415

Fax

(773) 768-6141

NPI assigned

Feb 15, 2007

Last updated

Jul 26, 2024By 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

Dr. Ernest Anderson Hayes, M.D.NPI 1083776678

Title

President

Phone

(312) 565-2267

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 7

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.

• Ernest Anderson Hayes, M.D.

  • Obstetrics & Gynecology Physician
  • Hazel Crest, IL
  • NPI 1083776678
  Medicare reassignment Authorized official
• Jason Tsai Chen, MD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1972543239
  NPD
• Kenneth Leon Bray, MD

  • Obstetrics & Gynecology Physician
  • Oak Park, IL
  • NPI 1740295161
  NPD (past)
• Sharon Michele James, MD

  • Obstetrics & Gynecology Physician
  • Chicago Heights, IL
  • NPI 1659385128
  NPD (past)
• Arpit Suresh Shah, DO

  • Cardiovascular Disease Physician
  • Chicago, IL
  • NPI 1346498292
  NPD (past)
• Suresh Shah, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1518040617
  NPD (past)
• Lisa Chanel Jackson, M.D.

  • Obstetrics & Gynecology Physician
  • Beaufort, SC
  • NPI 1912923996
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1063555456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E RANDOLPH ST",
            "address_2": "SUITE 3730",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017329",
            "telephone_number": "312-565-2267",
            "fax_number": "312-861-9415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8012 S CRANDON AVE STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606171124",
            "telephone_number": "773-356-5415",
            "fax_number": "773-768-6141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3330 W 177th St",
            "address_purpose": "LOCATION",
            "city": "Hazel Crest",
            "state": "IL",
            "postal_code": "604292184",
            "country_code": "US",
            "telephone_number": "708-333-3030",
            "fax_number": "708-914-6020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORCHID SUITE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "ANDERSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-565-2267",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "03643976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.